Systems for preventive care seek to provide healthcare services to citizens at risk of developing disease. In doing so they wrestle with identifying the citizens at risk of developing lifestyle-related disease and with reshaping the existing healthcare infrastructure into effective health offers for these citizens. In this study we analyze how a system for preventive care was enacted through a pilot implementation. The temporariness of the pilot implementation was, we argue, central to its contribution toward bootstrapping the system. By being temporary the pilot implementation became a means of acquiring clinical evidence for the cost-effectiveness of the system prior to committing to its long-term and large-scale use. The temporariness also legitimized temporary solutions to issues that otherwise made it difficult to bring actors, practices, and technologies into alignment. Once aligned, even if merely temporarily, the resurfacing of these issues after the pilot implementation will be shaped by the experiences from the pilot implementation. In this way pilot implementations have a generative role in infrastructure evolution; they are not merely tests but help bootstrap systems by making alignment manifest and benefits salient. We discuss this generative side of learning in pilot implementations and the extent to which they can enact a system by bootstrapping it.

中文翻译：

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试点实施的社会-时间观点：引导预防保健

预防保健系统寻求为有患疾病风险的公民提供医疗服务。在这样做的过程中，他们竭尽全力确定有患上与生活方式有关的疾病风险的公民，并将现有的医疗基础设施重塑为这些公民的有效医疗服务。在这项研究中，我们分析了如何通过试点实施制定预防性护理系统。我们认为，试点实施的临时性是其对引导系统的贡献的核心。通过暂时实施，试点实施已成为在承诺长期和大规模使用之前获取有关该系统成本效益的临床证据的一种手段。暂时性还使临时解决方案合法化，否则将使参与者，实践，和技术融为一体。一旦达成一致，即使只是暂时的，在试点实施之后这些问题的重现将取决于试点实施的经验。通过这种方式，试点实施在基础设施发展中具有创生作用；它们不仅是测试，而且还通过使对齐方式明显和明显受益来帮助引导系统。我们讨论了试验性实现中学习的这一生成方面，以及他们可以通过引导系统来实现系统的程度。它们不仅是测试，而且还通过使对齐方式明显和明显受益来帮助引导系统。我们讨论了试验性实现中学习的这一生成方面，以及他们可以通过引导系统来实现系统的程度。它们不仅是测试，而且还通过使对齐方式明显和明显受益来帮助引导系统。我们讨论了试验性实现中学习的这一生成方面，以及他们可以通过引导系统来实现系统的程度。