Large-Scale EHR Suites and Path-Dependence
Gunnar Ellingsen1, Morten Hertzum2, Bente Christensen3
1UiT - The Arctic University of Norway, Tromsø, Norway.
Studies in Health Technology and Informatics
|July 1, 2022
Summary
Implementing large electronic health record (EHR) systems restricts future technology choices. This study examines how past EHR decisions in Norway, Denmark, and Finland impacted alternative solutions.
Area of Science:
- Health Informatics
- Information Systems Management
Background:
- Electronic Health Record (EHR) suites are complex IT systems essential for modern healthcare delivery across various settings.
- Implementing large-scale EHR systems demands significant time, financial investment, and human resources for planning and execution.
Purpose of the Study:
- To investigate how prior decisions regarding EHR system implementations influence the availability of future technological alternatives for healthcare organizations.
- To analyze the impact of large EHR suite adoptions on strategic flexibility in healthcare IT decision-making.
Main Methods:
- Case study analysis focusing on the Health Platform program in Central Norway.
- Examination of EHR implementation timelines and vendor choices in Denmark (2016) and Finland (2018) as comparative examples.
- Qualitative assessment of decision-making processes and technological path dependencies.
Main Results:
- Past decisions on adopting specific large-scale EHR suites, such as Epic in Norway, have demonstrably narrowed the scope of subsequent technological options.
- The extensive resources and planning required for EHR implementation create lock-in effects, limiting agility in adopting newer or alternative health IT solutions.
- Healthcare providers may face challenges in pivoting to different or emerging technologies once a major EHR system is in place.
Conclusions:
- The selection and implementation of large EHR systems create significant technological path dependencies, constraining future strategic choices in health informatics.
- Decision-makers must carefully consider the long-term implications of EHR choices on technological flexibility and innovation within healthcare systems.
- Future research should explore strategies to mitigate lock-in effects and promote adaptability in healthcare IT infrastructure.
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