Growing Networks: Detours, Stunts and Spillovers Margunn Aanestad, Ole Hanseth Department of Informatics, University of Oslo, P.O. Box 1080, NO-0316 Oslo, Norway Abstract: Designing and developing technologies used to support distributed cooperation across organisational boundaries is challenging. Traditional design strategies do not appear to be suited to the situation at hand, as we will have to deal with vague visions rather than defined requirements, and most importantly, the development has to happen in a complex setting with a multitude of stakeholders, over whom no single actor has control. This paper describes the exploratory and iterative development of a telemedicine infrastructure in a hospital department. The need to enrol partners for development as well as for use required detours from the original goals. In this case the detours took the form of stunts, individual transmission events that were not parts of a grand plan, but which emerged in an ad hoc manner. Even if the main objective of the stunts was on an immediate nature, related to their successful accomplishment, the experience provided spillover knowledge that accumulated and proved valuable. Thus, far from being just a secondary and non-productive activity, the stunts provided the core learning situations on the project. Keywords: CSCW, video conferencing, field study, design methodology, video communication. 1. Introduction New multi-media information and communication technologies are widely assumed to enable a wide range of new medical services, usually labelled telemedicine. Telemedicine services can be developed based on a wide variety of technologies, from video conferencing technologies supporting synchronous communication to e-mail technologies supporting asynchronous communication. The use areas also varies widely; telemedicine services may support diagnostic as well as treatment processes, they may be used in emergency as well as non-emergency situations, and in non-patient-related activities like teaching and meetings. New services may cut across levels and boundaries; they may support work and communication both within a medical profession and between different professional groups, as well as communication and collaboration between primary care centres and hospitals, and between hospitals on a national or global scale. Most users should share the specific technological solutions, for instance, standard infrastructural technologies and services like e-mail and real time video conferencing. In addition functions designed and implemented because of specific needs of larger or smaller groups are needed. This implies designing new technological solutions; it is not just about organizational implementation of e-mail or video-conferencing solutions. If these grand visions shall become reality, an extensive, global and highly heterogeneous information infrastructure has to be built. The challenges