Big is Beautiful: Electronic Patient Records in Large Norwegian Hospitals 1980s – 2001

OBJECTIVES: This paper aims to describe and analyze the prolonged efforts - spanning close to two decades - of developing and using electronic patient records in the large, university-based hospitals in Norway. METHODS: This study belongs to an interpretative approach to the development and use of information systems. RESULTS: The increase in organizational, institutional, political and technological complexity has been seriously underestimated. This paper describes and analyses the prolonged efforts - spanning close to two decades - of developing and using EPRs in the large, university-based hospitals in Norway. The investments involved were considerable, implying that a crucial aspect of these efforts has been the way alliances have been forged with public institutions and agendas. CONCLUSIONS: The conditions for small-scale, bottom-up and evolutionary approaches never succeeded in constructing themselves as a viable alternative to the larger, more sweeping electronic patient record initiative, reiterating a more general tendency to privilege the more comprehensive and daring projects.