Cloud computing provides individual and organisational users the on-demand, scalable and reliable computing resources and can be deployed as a public, private, community or hybrid cloud.
The "top down" nature of the national programme has, despite ensuring necessary high level leadership and support, 12 contributed to a lack of organisational and user involvement in decision making.
A recent study shows that new distinct subfields have emerged in the last years representing the growing influence of the Internet and of organisational and user driven perspectives [ 12].
Despite some early benefits, particularly in relation to infrastructure and internal capacity development, our results show that software systems have as yet had difficulty fulfilling organisational and user needs.
The first Cochrane systematic review of paying providers for performance in low and middle income countries (LMICs) concluded that 'almost all dimensions of potential impact remain under-studied, including intended and unintended impact on health outcomes, equity, organisational change, user payments and satisfaction, resource use and staff satisfaction' [ 6].
Especially in extended health networks realising inter-organisational communication and co-operation, authorisation cannot be organised at user level anymore.
In the case of self-management, these models demonstrate how different service user, organisational, clinical factors and interventions either positively or negatively influence service user flow through the diabetes pathway [ 36, 37].
The systematic collection of data to consider barriers at organisational levels and user experience makes this a broader and more dynamic process than could be achieved merely through professional reflective practice.
The software in question was nationally procured, which meant that organisations, although to some extent free to choose which 'releases' (i.e. versions) they wished to implement, were presented with a fixed set of core releases that allowed limited customisability at either an organisational or group/individual user level.
