Aim: To study the objectives, processes, and ideologies expressed during participatory design of information systems (PDIS) in health care.
Design: Longitudinal documentation of project meetings by video recording. Grounded theory development in three steps.
Setting: Systems development project in primary care.
Results: The developing system was discussed mainly from a clinical and practical, as opposed to a technical, viewpoint. The design decisions were related to societal-level participants and institutions. This external influence on design decisions was mediated by design voices in discussions, each having its own scope.
Conclusions: The social environment has to be considered when applying PDIS in health care. Instructions for nondesigners can be used to introduce them to the design objectives, processes, and ideologies on which PDIS is based and to support them when relating clinical and practical design questions to the existing social constraints and norms.