Clinical Practice Guideline Management Information Systems: Cancer Guidelines as Boundary Spanning Tranformable Objects of Practice

The paper elaborates on the concept of transformable boundary artifacts and their role in fostering knowledge-based work in cross-organization virtual communities of practice. The domain of investigation is clinical practice guidelines development for cancer. By reviewing the social worlds involved, we claim that guideline development is a boundary spanning activity which can be facilitated through social networking tools of a Guideline Management Information System. Such a system is then described, focusing on the way it appropriates `plasticity´ to make guidelines cross social, institutional and technological boundaries. Contrasting earlier efforts, a key contribution of the research presented is that it emphasizes the dialogue and the intrinsic properties of developing (rather than interpreting) guidelines in collaborative settings.