The politics of networking technology in health care

The theme of the paper is the tension between centralization and the need for standardization versus the need for locally developed organization and use of information technology. Unanticipated side effects have always existed in IT-based organization change. However, the trend towards integration, both within and across organizational boundaries, may amplify the diversity and scope of such effects, thus making them more dificult to deal with. We will explore the tensions between local and centralized control on three levels: how networking technology applications can support centralization and decentralization of control, how standards and standarization processes deal with the central/local tension, and how well established information system design techniques such as modelling and formalization cope with this tension. The strategies for dealing with these political issues, we argue, are participatory and evolutionary standardization.