Big is Beautiful: Electronic Patient Records in Large Norwegian Hospitals 1980s – 2001

Summary

Objectives: This paper aims to describe and analyze the prolonged efforts – spanning close to two decades – of developing and using electronic patient records in the large, university-based hospitals in Norway.

Methods: This study belongs to an interpretative approach to the development and use of information systems.

Results: The increase in organizational, institutional, political and technological complexity has been seriously underestimated. This paper describes and analyses the prolonged efforts – spanning close to two decades – of developing and using EPRs in the large, university-based hospitals in Norway. The investments involved were considerable, implying that a crucial aspect of these efforts has been the way alliances have been forged with public institutions and agendas.

Conclusions: The conditions for small-scale, bottom-up and evolutionary approaches never succeeded in constructing themselves as a viable alternative to the larger, more sweeping electronic patient record initiative, reiterating a more general tendency to privilege the more comprehensive and daring projects.

Keywords

Electronic patient record systems - evolutionary approach - large hospitals - development strategies

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