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
