Large-Scale EHR Suites and Path-Dependence

Abstract

Large-scale electronic health record (EHR) suites are expected to cover a broad range of use scenarios for healthcare workers in hospitals, nursing homes, home-care services, and general practitioner (GP) clinics. However, preparation for the implementation of EHR suites requires years of detailed planning and consumes considerable financial and human resources. A key problem, then, is that there is less room for decision-makers to consider promising alternative solutions both before and after the implementation of EHR suites. On this basis, we explore how past decisions on EHR suites limit future technological alternatives. Empirically, we focus on the Health Platform program in Central Norway, where the goal is to implement the U.S. Epic EHR suite in 2022, following similar implementations in Denmark in 2016 and Finland in 2018.