Socio-technical Challenges of Large-Scale EPR Standardization in Healthcare.

Abstract

In this thesis I present empirical insight to socio-technical challenges of standardising large-scale healthcare information infrastructures (II). The main focus was how to balance the requirements between technological, organizational, and user related requirements in large-scale IIs, as well as the power balance between the actors, and the need for extensive user involvement in such standardization. I have used information infrastructure, CSCW, and standardization as the theoretical frameworks and the research is based on a 4 year study, which methodologically, adheres to qualitative interpretive research. The most important findings from this study relates to the need for close collaboration between technology, organization and system users in large-scale healthcare standardization, hence the main contribution of this thesis is the need for closer interrelation between the archetype standards and the EPR system than the two level model presents. I emphasize the importance of balance between user involvement and the efficiency of the standardization processes including keeping the end users as the main developers of the archetype standards. In such large-scale standardization effort including numerous users, it was important to address the power relations between the actors in the standardization and how this influence the outcome of the work.