Restructuring of the healthcare system and the diffusion of telemedicine.

This contribution focuses on the medical applications of new information and communication technologies (NICTs). We discuss the paradoxical nature of the spread of these technologies, related to the discrepancy between the promises held out by their use in a healthcare system searching for new mechanisms of coordination and their actual implementation, involving a series of experiments that to date have been short-lived. We then argue that solving this paradox requires understanding the complexity of the interaction process between NICTs and organisational changes. Thus while NICTs can facilitate the restructuring of provider networks, one of the principal challenges facing healthcare systems, they also reveal the tensions engendered by some new formal coordination mechanisms.