1) Integrating different health IT systems in India was challenging due to a lack of political support for certain aspects and systems not being equally supported. 2) Prior to integration, different systems did not work together, forcing staff to re-enter data into multiple systems to access needed information and data. 3) The article discusses how e-infrastructure can provide shared access to data and computing resources for research, and how patient and geographic data can be more easily analyzed and reported regularly through integration. However, the article is biased as it was written by those implementing the DHIS system.

1. Configurable Politics and Asymmetric Integration: Health e-Infrastructures in IndiaIntegrated e-infrastructure is beneficial for all, but it is hard to integrate when the politics do not support all aspects.

2. Pre-integration Different systems that did not work together and were not equally supported forced staff to do more work by making them re-enter data into different systems to get the different outcomes they needed. Some data also would get left out because it was in a different system.

3. Why e-Infrastructure?What is it? Research carried out regionally or globally through Internet collaborationsE-Infrastructure can provide researchers with shared access to large data collections, advanced ICT tools for data analysis, large-scale computing resources [1]More specifically patient and GIS data can be analyzed and reported easily on a regular basis[1]”What is e-Infrastrucutre” JISC. http://www.jisc.ac.uk/media/documents/publications/einfrastructure_rtf.rtf.

4. Why is it asymmetrical? Politics have a large affect on how systems can be integrated. This is because it all depends where the money comes from.$$

5. How did HISP succeed with asymmetrical integration? Being flexibleBy creating a tool that can be up front or behind the scenes compatible in many different situations and over time

6. Critiques This article is told from the point of view of the underdog—a NGO that was not always politically supported. Although the researchers conducted interviews with many parties, I think the article was biased. The authors were involved with the process and trying to implement DHIS. Seemed like it was trying to sell itselfBarely mentioned things like training and lack of Internet connection

7. Integration in Interlibrary LoanILLiad software has Z39.50, Amazon, Google, Innovative, and many other options integrated in it’s software

8. Discussion QuestionIf everything is integrated then won’t everything be a monopoly?