Establishing an infrastructure for tele-care: combining the socio-technical and the clinical Giovanni Rinaldi (1), Mike Martin (2), Antonio Gaddi (1) (1) University of Bologna Italy, (2) University of Newcastle UK Abstract ICTs offer great opportunities for delivering tele-medicine and social care in a number of domains including services for the elderly. This area of application, however, presents many challenges at many different levels. The purpose of this chapter is to describe an approach followed, and explore some lessons learned in Bologna (Italy). The stated objective of these developments was to maintain independent living, in their own homes, by elderly people for as long as possible and as cost effectively as possible. Thus the approach was an attempt to address the challenges both of the quality and the economics of care. Part of the background to the project was that, over the previous ten years, more then three hundred elderly people had been involved in different home care projects in the Municipality. These initiatives started with traditional approaches to the integration of home care applications (tele-medicine devices or software applications) using proprietary and ad hoc mechanisms and culminated in the development of the concept of a technical and organizational platform with the potential to overcome many of the problems of traditional e-Care applications and to exploit some of the new potentialities offered by network technologies such as eHealth and web2 in health. 1. Introduction and description of the project This chapter presents a multi-perspective view of what turned out to be a complex and emergent project. The attempt to discuss the work in terms of its clinical, political and technical backgrounds, its objectives and aspirations, the complex unfolding of events that took place and the learning and insights that were achieved, inevitably produces a narrative which spans a number of disciplinary perspectives. This underlines the multi-faceted nature of the task of introducing new forms of care through new channels and infrastructure. The most inclusive expression of the requirement that the OLDES project addressed was “to promote and sustain the wellbeing of older people, at home and in the community, by providing an infrastructure and services capable of supporting the operation and governance of a dynamic and participative economy of care services”. This chapter describes the reference architecture which creates a