Integration as interdependent workaround

PurposeThe paper focuses on how new, poorly charted complexities emerge when disparate systems in healthcare are integrated across organizational, geographical or professional boundaries.MethodInterpretive and longitudinal.ResultsThe 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.ConclusionThe 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.

► Inertia of existing systems and practices hampers change.
► Interdependencies of integrated systems result in escalation of the complexity.
► Integration makes local workaround interdependent across practices.
► The analytical concept of information infrastructure proves useful in dismantling a local/global separation.