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Title: The tension between national and local concerns in preparing for large-scale generic systems in healthcare
Authors: Ellingsen, Gunnar
Hertzum, Morten
Melby, Line
Keywords: Large-scale generic systems;Electronic health records;Epic;General practitioners;National concerns;Local concerns;Central Norway
Issue Date: 2022
Publisher: Springer, London
metadata.dc.relation.ispartof: Computer Supported Cooperative Work, Vol. 31
Series/Report no.: ECSCW
Abstract: Large-scale generic systems are typically adapted to local practice through configuration. This is especially important in healthcare, which involves a plurality of institutions and users. However, the decision to acquire a generic system in public healthcare is typically founded on regional and national health policy goals, which often are translated into various forms of standardization. As a result, national and regional health policy interests may stand in contrast to interests on the local level. Therefore, we analyze how national and local concerns are weighed against each other in the preparations for implementing large-scale generic systems in healthcare. We explore what role configuration plays and what the prospects are for long-term development. We contribute with insight into how the organizational consequences of generic systems are formed already in the preparation phase and point to how configuration easily results in standardization, thereby basically privileging national and regional health goals at the expense of local needs. Empirically, we focus on the preparations for implementing the Epic electronic health record in Central Norway.
metadata.dc.identifier.doi: 10.1007/s10606-022-09424-9
ISSN: 0925-9724
metadata.mci.conference.sessiontitle: Full Papers
Appears in Collections:ECSCW 2022 Full Papers

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