GIANLUCA MISCIONE

The most critical distinction in this organizational logic is to be or not to be - in the network. Be in the network, and you can share and, over time, increase your chances. Be out of the network, or become switched off, and your chances vanish since everything that counts is organized around a worldwide web of interacting networks Although Castells [1996] may sound reductionist, the centrality of networks in contemporary world is widely accepted. This is increasingly important because networks’ growth is not only geographical, it is taking place across disciplines and fields of activity, too. The improvement of health standards in Africa (and elsewhere as well) through information technologies cuts across many boundaries between medicine, politics, innovation, development and cultures. One of the bottlenecks in the development of effective healthcare systems (which also rely on health information systems, patient record systems, laboratory systems) is the centralized and fragmented nature of specific health care activities, lack of coordination, poor quality and use of information, and the complex nature of health organizational context. Poor focus on the development of local expertise and the tendencies of neglecting of social and organizational issues are cited as major factors contributing to the problem of ineffective implementation of computerized healthcare systems. On the other hand, the macro level (intended as the rollout of a universal design) is problematic as well, because it proved to clash with the variety of contexts it has to deal with.