Evolving Systems – Engaged Users : Key Principles for Improving Region-wide Health IT Adoption

Sammanfattning: Many countries have formulated their eHealth visions and billions of dollars have been spent on supporting the eHealth development throughout the world. An important part of the development is the electronic patient record (EPR). To enable sharing and increase cooperation between care providers, most Swedish county councils have decided to use a region-wide EPR. The health professionals often experience numerous problems and consider the region-wide EPR to be too generic and require them to tailor their practices instead of the system evolving towards supporting their needs.The aim of the PhD research is to gain knowledge of adoption when deploying and using region-wide health IT systems. This is accomplished by studying, analysing and reflecting upon what region-wide health IT systems are and how professionals use them in their practice. In the research a grounded theory method has been used, which means that the empirical data, not theories and hypotheses, have driven the research process. The data-gathering methods have been interviews, observations, participating in meetings, questionnaires, seminars and conducting literature reviews.In order to be able to improve the adoption, a set of four key principles has been identified: (1) Evolving systems-Engaged users, (2) Treat IT deployment and usage as part of organisational development, (3) Identify, respect and support differences, and (4) Identify what must be customised and what can be centralised.These four principles challenge the traditional way of developing enterprise-wide IT and emphasise the importance that users must engage in the development, procurement and deployment process to identify their similar and unique needs and procedures. It is crucial that both the similarities and uniqueness are respected and supported. The similarities can be supported by a centralised, standardised solution, while uniqueness requires a customised solution. In order to accomplish that, the IT deployment and usage needs to be treated as an important part of the on-going organisational development, and the IT systems must evolve, i.e., be continuously developed in order to engage the users to participate.