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Mumbai needs to be transformed into a world-class city as stated in the 2005–2025 development plan of Municipal Corporation. For this initiative, hospital management information system (HMIS) has to be implemented across 400+ health facilities in the city.

A case study methodology was adopted to study HMIS implementation. Wave 1 of Phase 1 implementation of HMIS is carried out as a pilot project at Film City’s Hospital, Mumbai, which “go-live” on 21st June 2018. The work for hardware and software implementation was awarded to HardSystems and Solutions Limited and SoftSolutions India Private Limited, respectively, through e-tender.

Provision of inadequate quantity of hardware, slowness of network or system, non-satisfactory training after observation confirmation and sign-off process, lack of data entry operators, mismatch in numbering systems in blood bank and many other challenges concerned with the specific departments had become a major impediment in the efforts to maximize number of patients registered into HMIS.

Even after providing many clinical and managerial benefits, being the first cloud-based centrally located HMIS in any of the hospitals in the city, it imposes a major challenge for the management in terms of resistance of employees toward technology and need for the adoption of theoretical models for implementing change for the overall organizational development.

To the best of the authors’ knowledge, no other teaching case study is conducted to study the HMIS implementation in large-scale public health-care services. This is a dummy case study for teaching exercises. The identity of the stakeholders, organizations and events has been masked to maintain confidentiality.

The paper explores the emergence of smart city governance with a particular focus on the cognitive value of the new technologies and the different accountabilities emerging in the digital infrastructures attempting to visualize and rationalize urban dynamics.

Drawing on ethnographic, netnographic and interview data from an empirical case study of the Smart and Wise City Turku spearhead project, the study builds on the assumption that smart cities emerge from the interaction between the characteristics of technologies, constellations of actors and contextual conditions.

The results report smart city activities as an organizational process and a reconfiguration that incorporates new technology with old infrastructure. Through the lens of the empirical examples, we are able to show how smart city actors, boundaries and infrastructures are mobilized, become valuable and are rendered visible. The smart cities infrastructure traces, values and governs actors, identities, objects, ideas and relations to animate new desires and feats of imagination.

In terms of implications to practice, the situated descriptions echo recent calls to leaders and managers to ask how much traceability is enough (Power, 2019) and limits of accountability (Messner, 2009).

The central theoretical concept of “thinking infrastructure” highlights how new accounting practices operate by disclosing (Kornberger et al., 2017) new worlds where the platforms and the users discover the nature of their responsibilities to the other. The contribution of this paper is that it examines what happens when smartness is understood as a thinking infrastructure. Different theorizations of infrastructure have implications for the study of smart cities. The lens helps us grasp possible tensions and consequences in terms of accountability that arise from new forms of participation in smart cities. It helps urban governance scholarship understand how smartness informs and shapes distributed and embodied cognition.