  This paper examines two parallel case studies to promote remote medical
consultation in Ghana. These projects, initiated independently by different
researchers in different organizations, both deployed ICT solutions in the same
medical community in the same year. The Ghana Consultation Network currently
has over 125 users running a Web-based application over a delay-tolerant
network of servers. OneTouch MedicareLine is currently providing 1700 doctors
in Ghana with free mobile phone calls and text messages to other members of the
medical community. We present the consequences of (1) the institutional context
and identity of the investigators, as well as specific decisions made with
respect to (2) partnerships formed, (3) perceptions of technological
infrastructure, and (4) high-level design decisions. In concluding, we discuss
lessons learned and high-level implications for future ICTD research agendas.
