Implementation and use of an electronic health record: measuring relevance and participation in four hospitals

For more than a decade, there have been claims of the advantages of Electronic Health Records (EHR). Nevertheless the results of these IT-based innovations do not meet the expected improvements in healthcare performance. This paper investigates this phenomenon by studying relevance and participation during the implementation process of EHR in four different hospitals. From the case studies it can be concluded that the relevance of HER merely focuses on the availability of information at any time and any place. This employment of relevance does not meet end-users' expectations and is insufficient to accomplish the aspired improvements. The used participation approaches do not facilitate diffusion of EHR in hospitals. Participation from the start can help to leverage the relevance of the EHR, but the other way around more relevance can also help to motivate participation. A careful balance is needed to avoid a deadlock situation (No relevance, No participation).