One example of infrastructure is the health system. The system is made up of many parts – patients, doctors, hospitals, medications, and many others. Each of these different aspects can be considered to be a top element, a bottom element, or a middle element (middleware).
Examples of bottom elements in the health care system are hospitals, doctors’ offices and clinics, and the equipment – and medications – that are found inside them (scales, stethoscopes, X-Ray machines, etc.). These are the “networks”, to and through which “application programs” travel. In this case the “application programs”, or top elements, are patients. Between these top and bottom elements are many different types of middleware. This includes doctors, nurses, technicians, and pharmacists.
These different types of middleware are elements that connect the patients with the hospitals and offices – the middleware elements inhabit these places, allowing patients to use theses spaces and equipment. Patients come to hospitals to fix medical problems, and doctors help them to do this by diagnosing them (either based on information given by the patient, or information obtained from tests) and creating a course of action to help the patient get better (for example, by suggesting a new diet, physical therapy, or prescribing a medication). Nurses help by administering tests and monitoring vitals, and pharmacists help by preparing medications. Any or all of these middleware elements come together in each case to help the patient.
In the case of health care, the middleware layer is fairly static. The main goal of the health care industry is to diagnose and treat patients, which is what the middleware layer works to do – this doesn’t change much, except in the case of new techniques. But even in the case of new techniques, it is just the way the goal is accomplished that changes, and not the goal itself.
The standards of health care, and thus the middleware layer, are set by the patients. Patients utilize doctors in order to get better, and they create this expectation of the health care industry. These expectations come from the general public, despite the fact that the health care middleware is only semi-public. Although in theory it could be entirely in the public domain, many people do not have access to it because they lack health care, or they lack the financial means to health care. So, while such people help to set the standards for the health care middleware, they may not be able to actually utilize it.
Ultimately, without the middleware of the health care system, hospitals, clinics, medical equipment, and medications would be much less useful to the patients who need it.