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Exploring Electronic Patient Records in Hospitals

This research delves into the realm of Electronic Patient Records (EPRs) within hospitals, examining their impact on healthcare workflows and patient care. The study focuses on interpretive IS research methods, the role of patient records in hospitals, challenges in EPR implementation, and the changing landscape of healthcare driven by digital transformation. Insights into information flow, governmental action plans, and the complexity of EPR systems in different healthcare settings are highlighted.

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Exploring Electronic Patient Records in Hospitals

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  1. Studying EPRs in hospitals Gunnar Ellingsen University of Tromsø NSEP Doing research on EPRs in hospitals

  2. My background • Researcher at the University of Tromsø • Ph.D. from IDI-NTNU on EPR systems in hospitals • IT-consultant at the University hospital of North Norway Doing research on EPRs in hospitals

  3. Structure of the presentation • Interpretive IS research • The role of the patient record in hospitals • The Norwegian health care sector and expectations to EPRs • Brief overview on EPR systems • How a changing health care sector shape the EPR Doing research on EPRs in hospitals

  4. Interpretive IS research • Cannot see IT in isolation • Context, interaction, interpretation • No given ‘truth’ • No neutral IS • The data collection (ethnography) • Participant observation • Interviews • Video • University hospital North Norway Doing research on EPRs in hospitals

  5. Becoming an insider “In here you will be taken for a physician if you wear that white coat” (Physiotherapist in the Dept. of Rehabilitation) Doing research on EPRs in hospitals

  6. The role of the patient record in hospitals • A working tools for health personnel • Organisational memory • Communication and coordination • Education and research • Collaboration between professional Doing research on EPRs in hospitals

  7. Characteristics of the paper-based record • Clear boundaries: what is there is all there is • The thickness of the paper record • The leaf effect • Top-down versus bottom-up • Mobility • Structured organisation of the content Doing research on EPRs in hospitals

  8. The structure: a threat to collaboration? Doing research on EPRs in hospitals

  9. Challenges when starting to useEPRs • Maintaining the comprehension that there should be clear boundaries to the environment • Enforcing the division of labour • Formalising the writing process • Making the EPR a tool for health personnel when patients are hospitalised • The curve book • Overview versus searching for specific information Doing research on EPRs in hospitals

  10. Diving into the problems of the Norwegian health care sector • An expensive sector • 55 billions budget for the Regional health enterprises • 45 billion spent through the municipalities • From treatment to prevention • The population is getting older Doing research on EPRs in hospitals

  11. Information flow Doing research on EPRs in hospitals

  12. How is the EPR instrumental in change - Governmental action plans • More health for each bIT (1997-2000) • The EPRs as a means for “freeing time for the health care workers” • Electronic Interaction in the Health and Social Sector (2001-2003) • Change work processes • Ensure quality improvement and coordinate treatment of patients. • Interplay 2007: Electronic cooperation in the health and social sector (2004-2007) • Improve process flow Doing research on EPRs in hospitals

  13. Three hospital-based EPR systems Doing research on EPRs in hospitals

  14. Complex organisations Complexity of making EPRs University hospitals Middle-sized hospitals Primary care Size of health institution Doing research on EPRs in hospitals

  15. The failure of the monolith: The Medakis project at its closure • Seven years of development • Terminated in 2003 • A failure when compared to the goals • Replacement of paper • Dissatisfaction: functionality, integration, user-participation • Local problems, global strategies Doing research on EPRs in hospitals

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