Gianluca Miscione

Telemedicine in the upper amazon: interplay with local health care practices

This article is based on the introduction of a telemedicine system in the jungles of northeastern Peru. The system was designed by a European consortium led by a Spanish polytechnic in cooperation with two universities in Lima and the Peruvian Ministry of Health. The purpose of the system was to improve health conditions by extending science-based medicine into a region with well-established traditional healing practices. The central analytical focus of this article is on the interplay between the public health care system, which used the telemedicine system, and local health care practices. The manner in which scientific medicine was delivered through information technology and public health care services is analyzed in terms of the health personnels activity, the local populations conceptions of health, and the trajectories followed by patients seeking recovery. The author participated in the design of the second evaluation of the telemedicine system and acted as a participant observer in the regional hospital and peripheral clinics. In addition to interviewing health care staff from the study area, the author also met with traditional healers, and patients in the districts whether or not they were involved in the telemedicine project. New institutional theory provided the analytical framework for the interpretation of the observed behavior of the public health care staff, traditional healers, and potential patients. Empirically, this study describes the informal aspects of the functioning of the telemedicine system, and its partial mismatch with the definitions of health and illness employed by local communities and healers. An argument is made that peoples construction of their health, which is embedded in their normal patterns of action, should be identified, and then considered in the design, implementation, and evaluation of future telemedicine projects. This article problematizes an approach to telemedicine-based health development that is weakly accountable to local social contexts and their diversity.

Examining trust in mobile banking transactions: The case of M-PESA in Kenya

This chapter examines how trust can emerge and be sustained in the context of mobile transactions. It focuses on M-PESA, a mobile banking system in Kenya, using data from an ethnographic study that was deployed in Kibera—one of Africa’s largest slums. We present research in progress and discuss two main findings. Firstly, interpersonal trust relations between the customers and agents are weak. Customers do not trust the agents with their money. Secondly, the institutional trust relations between the customer and Safaricom, the mobile service provider offering M-PESA, are strong. This means that customers use the M-PESA service because they believe that their money will be kept safe by Safaricom. After providing empirical evidence to substantiate these claims, this study concludes by suggesting questions for future research.

Citizen Surveillance of the State: A Mirror for eGovernment?

This paper discusses, conceptually and empirically, the role of geographic ICT (geoICT) and virtual globes (e.g. Google Earth) at the interface of public policy and citizens. Our preliminary findings from on-going field work in an Indian city and in Zanzibar suggest that virtual globe technology can potentially transfer to citizens surveillance power, traditionally held by the government. Starting from the traditional electronic government framework, where bureaucracy acts as a filter between policy makers and citizens with grievances, we outline an emerging framework where commercial virtual globes act as mediators between policy-makers and citizens. We show that the emerging framework holds the potential of allowing citizens concerned, in our case, about the quality of water services, to influence policy makers directly. The virtual globe acts as a mirror to the traditional eGovernment framework and lends a different societal visibility both to public services provision, and to localized citizens’ needs.

Relationality in geoIT software development: How data structures and organization perform together

Abstract Constructivism in geo-information science has emphasized what happens to geo-information technologies (geoIT) after the design stage, when systems and applications are used in real life. Current constructivist views, however, have focused less on other aspects such as software development practices. This paper adopts a similar constructivist epistemology, but looks at how geoIT and people are entangled in the development stages. We discuss the case of the migration of GIS software to Free and Open Source license. This case provides clear empirical evidence of the entanglement of humans and artifacts during the development of GIS technologies. Through an analysis of archived material (such as mailing lists), and of the software code, the paper describes how the integration of a new software (the library Fast Fourier Transformation in the West) was hindered by the different data structures of the original GIS and the new software. The case study we propose shows how actual software development practices may contrast with the well-established rhetoric of technical efficiency of the algorithms. In addition this choice also illustrates the organizational aspects of developing GIS and the different weights that are given to computational resources and organizational resources.

A Geographic and Mixed Methods Approach to Capture Unequal Quality-of-Life Conditions

The aim of this chapter is to present a methodological approach to map unequal quality-of-life and citizen’s self-perceived living conditions. The objective is to critically explore new approaches where the combination of multiple sources of information collected via mixed methods offers new insights at the same time as raises new challenges. This chapter draws from various case studies carried out in the global South and North. All the cases made use of adjustments of our framework that combines measures of objective and subjective quality-of-life in a mixed method approach. Although the cases are located in cities of different countries, the results show the emergence of similar questions and concerns related to the construction, use and validity of the collected information and poses new questions about what knowledge can be derived from it. The results also show the policy relevance of mapping and explaining self-perceived quality-of-life conditions for targeting and implementing remedy policies.

Organizational Learning in Health Care: Situating Free and Open Source Software

Free and open source software (FOSS) has been attracting the interest of organizations involved in the development and implementation of information and communication technologies (ICTs) in developing countries foryears. ICTs for development initiatives often have public sector orientations, as governments’ ICT policies are expected to shape and support socio-economical development. The usual mismatch between formal bureaucracies’ functioning, the usual top-down software development schemes, and the actual trajectories of development initiatives (mostly run by international agencies) provides a promising empirical field. This paper intends to discuss the connection between FOSS and organizational learning in contexts where the usual assumptions about them cannot be taken for granted. It is argued that the relevance of open technologies as public goods is in allowing organizational learning in public administration. Such a focus on the organizational aspects would complement existing studies on the economical relevance of FOSS.

Tribal Governance: The Business of Blockchain Authentication

The blockchain technology offers a novel mode of distributed authentication, which does not depend on a central authority. We consider this novelty against established governance modes. We illustrate our argument by paying special attention to blockchain-based authentication functions in the empirical domain of land registries across the world. Based on interviews with representatives from organizations deploying blockchain, and content analysis of related grey literature, we discuss established governance idealtypes against what the rivalry that cryptocurrencies and blockchains bring to digital settings. After referring to market, hierarchy, network, and bazaar, we conclude outlining the prospects of a different, blockchain-related governance mode called ‘tribal’ that better captures the ‘togetherness’ which rivalry originates.

Infrastructures and their invisible carnivalesque

33rd European Group of Organizational Studies (EGOS) Colloquium, Copenhagen, Denmark, 6-8 July 2017

Overflows of Technological Innovation in Emerging Economies: The Case of M-Pesa

This paper contributes to the debate on technological innovation in the domain of emerging economies. Using the example of M-Pesa, the well-known m-banking application developed in Kenya, we argue that technological innovation in emerging markets should be seen as arising from an assemblage of actors in which context matters. We develop this argument by drawing on concepts from the sociology of markets. Through our detailed empirical analysis of the career of M-Pesa in Kenya, we propose that innovation in this case is emergent, highly provisional and politically constituted. Overall we provide insights into the non-technological issues critical to technological innovation in emerging economies. We will conclude by discussing the implications for future mobile technological innovation specifically and technological innovation more broadly in emerging economies.

The tool that has to build itself: The case of Dutch geo- data

Standardisation is one of tools of Electronic Government (EGov). It refers to the development where individuals and organizations develop and/or adhere to standard IT solutions and associated work processes. Studies on standardization in information technology (IT) emphasize either only the technical side of standard construction (the ‘what’ and ‘how’), or the socio-organizational side of the contextual processes in which standards emerge (the ‘who’ and ‘when’). Our article has an alternative, socio-technical, approach, which emphasizes ‘where’ standards crystallize. Our empirical field to find where crystallization occurs concerns the geoIT sector. Through a qualitative approach, the data show that standard crystallization occurs at the hubs of inter-organizational relations, rather than at the top or the bottom of formal organizations. This claim is important because it contradicts the common strategy of standardization, which is largely centralized. Even though government has centralized the creation and distribution of geoIT standards, their actual creation and crystallization occurs at a more decentralized level: across municipalities. The conclusion is that bringing the standardization discussion to a point of where standardization actually happens, provides a better understanding of the socio-technical dynamic of governance of inter-organizational IT.