The Origins of a Healthcare e-Booking System in the Municipality of Bologna

Since 1990, citizens living in the Municipality of Bologna have the possibility to visit dedicated offices present in hospitals and health centres in order to book specialist ambulatory services including visits and diagnostic activities. This is possible due to the creation of (probably) the first example of an e-booking system in Europe. This innovation for accessing healthcare services represents an opportunity for studying the encounter between enabling effects and constraining effects of the installed base. Specifically, in this case the institutional components of the installed base revealed themselves as obstacles for achieving innovation and only the large mobilization of political, organizational, and technological resources made it possible.