“MIPRES grew like a snowball and took us with it”: Evolution of a health information infrastructure

Abstract

This paper explores how the Colombian MIPRES system emerged as a nationwide ePrescription solution and, how it evolved into a backbone for the country’s Information Infrastructure. Our empirical qualitative study is based on the analysis of interviews conducted in the Ministry of Health, hospitals, insurance companies and patients’ organizations. In addition, documents and notes from ethnographic observations were analyzed. Information Infrastructure theoretical insights were employed to analyze the contextual conditions that shaped this evolution. Initially, MIPRES was conceived as a simple reporting system. Through its non-threatening strategy and alliances, it gained momentum like a snowball and, grew to become a central component of the Colombian health information infrastructure. Considered a “successful” implementation, MIPRES triggered a new network of relationships that exists in the background, it is invisible, and frequently taken for granted; thus we conclude that MIPRES wove around it the health information infrastructure of Colombia.