Managing integration work in an NHS electronic patient record (EPR) project

Area of Science:

• Health Informatics
• Information Systems Research
• Sociology of Technology

Background:

• The UK National Health Service (NHS) is undergoing digital transformation, including the adoption of electronic patient record (EPR) systems.
• Integrating new health IT systems requires careful consideration of existing clinical practices, technological infrastructure, and regulatory frameworks.

Purpose of the Study:

• To document the challenges encountered during the design and deployment of an EPR system within the NHS.
• To analyze the complexities of 'integration' when introducing new IT systems into established healthcare environments.

Main Methods:

• An ethnographic study was conducted.
• The research focused on the design and deployment phases of a specific EPR system in the UK NHS.

Main Results:

• The study identified significant difficulties in integrating the new EPR system with existing practices, technologies, and regulatory demands.
• The process of 'integration' generated diverse, interconnected, and often competing requirements.
• These competing requirements posed substantial obstacles to achieving effective and successful system deployment.

Conclusions:

• Successful deployment of health IT systems like EPRs is hindered by the multifaceted and conflicting nature of integration requirements.
• Achieving 'artful' system deployment necessitates addressing the complex interplay between technology, practice, and regulation in healthcare settings.