Prevenire i fallimenti organizzativi nei sistemi sanitari : La definizione di uno strumento di anticipatory governance a partire dal caso della telemedicina in Toscana

In the literature on the analysis of organizations more attention is devoted to positive cases rather than those of failure. Nevertheless, some authors have pointed out that negative externalities represent one of the constituent elements of everyday organizational practices, and that unexpected consequences are inevitable (Merton 1936). Therefore, the «dark side» of organizations deserve the same attention that is given to the «bright side» (Catino 2012). In the light of these considerations, the article focuses on the possible perverse effects, organizational myopias, and unexpected outcomes that may occur within a complex system, such as the healthcare system, following the implementation of telemedicine and the so-called «digital health». The research is based on a case study, and uses qualitative methodologies based on in-depth interviews. Through highlighting the case of the Tuscany Regional Health System, the article identifies critical issues and shortsightedness that could plausibly affect the entire Italian National Health Service (NHS).