Integration as interdependent workaround.
OBJECTIVE
The paper focuses on how new, poorly charted complexities emerge when disparate systems in healthcare are integrated across organizational, geographical or professional boundaries.


METHODS
Interpretive and longitudinal.


RESULTS
The paper illustrates empirically how the interdependencies of integrated systems result in escalation of the type, extent and degree of complexities that cuts across previously "local" systems and practices. This implies that a local workaround also becomes interdependent across practices.


CONCLUSIONS
The analytical concept of information infrastructure proves useful in dismantling a local/global separation, as it supports an empirical strategy of tracing out the concrete manifestations of how, where and when the "local" and the "global" are interdependent.
Department of Clinical Medicine, Telemedicine and e-Health Research Group, University of Tromsø, 9037 Tromsø, Norway. gunnar.ellingsen@hn-ikt.no
Gunnar
G
Ellingsen
Eric
E
Monteiro
Kristoffer
K
Røed
D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D057286:Electronic Health Records / Q000458:organization & administration*; D006282:Health Personnel / Q000458:organization & administration*; D006284:Health Plan Implementation; D006801:Humans; D007373:Interinstitutional Relations; D018511:Systems Integration