Building Smarter Healthcare for Smart Cities: Investigating the Infrastructural Dimension of Smart Services Provision Through an e-Prescription Case Study

The services provided by smart cities are based on complex information infrastructures composed of a broad range of interdependent but loosely coupled technological, organizational, institutional and legal systems. The development and evolution of information infrastructures enabling smart services provision follows logics and paths that are substantially different from the ones of self-contained technologies or plug and play applications. In this chapter, we argue that the investigation of these phenomena needs to be carried out with a case study approach, which looks not only at development but also at longer-term evolution dynamics. At the same time, a better understanding of information infrastructures logics and paths is highly relevant for policy makers and project managers, in order to be able to govern such initiatives. For the purpose of showing some of the key feature of this infrastructural dimension, this chapter analyses the development of an e-Prescription system in Italy. As many other digital services provided by smart cities, digital prescription service is the result of practices distributed across a network of actors and digital solutions, which work across organizations. In addition, they are at the intersection of multiple logics which aim at the creation of different public values such as economic—through expenditures control and efficient allocation of resources-, legal—through transactions traceability and doctors’ accountability-, and service quality—providing the users with better services through a smarter management of the information and resources. Thus, this case provides the occasion to examine the multilevel infrastructural complexity upon which smart cities initiatives are built, showing the mix of local, regional and national layers enabling a smart prescription services provision.