UiT - The Arctic University of Norway, Tromsø, Norway.
Nord University, Bodø, Norway.
Stud Health Technol Inform. 2021 Nov 8;286:33-37. doi: 10.3233/SHTI210632.
Large-scale electronic health record (EHR) suites have the potential to cover a broad range of use needs across various healthcare domains. However, a challenge that must be solved is the distributed governance structure of public healthcare: Regional health authorities regulate hospitals, municipalities are responsible for first-line healthcare services, and general practitioners (GPs) have an independent entrepreneurial role. In such settings, EHR program owners cannot enforce municipalities and GPs to come on board. Thus, we examine what tactics owners of large-scale EHR suite programs apply to persuade municipalities to participate, how strongly these tactics are enforced, and the consequences. Empirically, we focus on the Health Platform program in Central Norway where the goal is to implement the U.S. Epic EHR suite in 2022. Theoretically, the paper is positioned in the socio-technical literature.
大型电子健康记录 (EHR) 系统有可能涵盖各种医疗保健领域的广泛使用需求。然而,必须解决的一个挑战是公共医疗保健的分布式治理结构:地区卫生当局监管医院,市政府负责第一线医疗保健服务,全科医生 (GP) 则扮演独立的创业角色。在这种情况下,EHR 计划所有者无法强制市政府和全科医生参与。因此,我们研究了大型 EHR 系统计划所有者采用哪些策略来说服市政府参与,这些策略的执行力度如何,以及后果如何。从经验上看,我们关注的是挪威中部的 Health Platform 计划,该计划的目标是在 2022 年实施美国的 Epic EHR 系统。从理论上讲,本文的定位是在社会技术文献中。