Publications
Publications
- 2025
- HBS Working Paper Series
Crossing the Design-Use Divide: How Process Manipulation Shapes the Design and Use of AI
By: Rebecca Karp
Abstract
Existing literature often separates research on the design of innovations from their implementation and use, neglecting the role of selection—how organizations choose which innovations to implement. Although scholars suggest scientific approaches for selecting novel technologies, there is limited research on how these methods are practically employed in decision-making. This study addresses this gap by examining how organizations decide which innovations to implement and how the selection process influences their design and use. Drawing on a two-year ethnographic study, the research explores how 13 dyadic pairs of entrepreneurial firms and health system committees piloted AI-based medical diagnostic innovations. Committees, composed of members with polarized views on AI, formed coalitions reflecting these views. Dominant coalitions engaged in "process manipulation," strategically altering the piloting process to achieve self-interested outcomes while maintaining an appearance of rigor. Coalitions enthusiastic about AI scoped pilots to test basic uses, ensuring success, while skeptical committees tested advanced uses, hoping for failure. This manipulation constrained entrepreneurs' ability to advocate for their innovations and demonstrate market differentiation. The paper highlights the dynamics of process manipulation and its impact on AI innovation development and use.
Keywords
Citation
Karp, Rebecca. "Crossing the Design-Use Divide: How Process Manipulation Shapes the Design and Use of AI." Harvard Business School Working Paper, No. 25-034, January 2025.