Success of It Based Innovation in Healthcare: the Art of Implementation and Use of an Electronic Patient Record

Many information systems do not meet the expectations of the end-users. For electronic patient records (EPR) it is even worse, they are often not implemented yet. For more than a decade the society boasts the advantages of an EPR varying from millions of dollars to thousands of lives. Why do these IT based innovations not come to improvements of healthcare performance? This paper explores the transitions in the life cycle of an EPR from healthcare domain to information domain and back again. Both transitions have a large impact on the EPR success. Main result for theory is that the two major distinctions, Business and ICT and product versus process, lead to a strange dogleg in the lifecycle of information systems. The two major transitions form a cross on their own that we call the Relevance Gap and the Participation Gap. The old adagio “success is quality (relevance) times acceptation (participation)” is still valid. Main results from the empirical study are that: The relevance of EPR focuses on the availability of information anywhere anytime. The question is whether this is enough to start such big changes in healthcare. We conclude therefore that from the end user point of view the electronic patient record is not very relevant. The participation shows little involvement from the top management leading to a poor diffusion. In general from these four cases we conclude that when top management is participating that end users are less involved and when end users are highly participating, top management is less involved. Further research has to confirm these findings