The Challenge of Integration: (In)adequacy of Technical Solutions to Institutional Challenges
Integration in Public Health Informatics
In this chapter, we explore the wicked problem of fragmentation, and popular approaches to finding integration solutions to them. Most such solutions are driven primarily by technically focused logics. We explore the deeper reasons why such problems keep recurring, and why the currently available solutions remain insufficient. In the first section, we set up the fragmentation- integration problematic, arguing for more nuanced approaches for analysis and development of solutions. Next we explore the question of ‘why’ to understand the multiple logics that drive integration efforts. Following this, we analyse the question of ‘how’, referring to some contemporary approaches to address fragmentation, focusing on the Open Health Information Exchange, which is being presented as a modern solution to the integration problem in both rich nations and in low and middle-income countries (LMICs). Finally, we explore how the Expanded PHI approach can provide some novel insights to the problematic posed in this chapter.