Involving the User in Configuring a Large-Scale Electronic Health Record

User participation has been advocated as critical for the successful implementation of health information technology. However, user participation comes in different flavors, ranging from nominal participation (when users have no real influence on the development and implementation process) to transformative participation (where users have influence and ownership to the development and implementation process). In this study we have looked at how users, involved in the configuration and implementation of a large-scale health information system in Norway, assess their participative role. Based on semi-structured interviews with eight user participants we found that in their experience the participation fell short of transformative participation. This could account for part of the criticism the implementation has received.