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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Realising the shared electronic health record: a multi-site study of a national pilot implementation

Alternative title: Innføring av én felles pasientjournal: en kvalitativ studie av den nasjonale pilot-implementeringen i Midt-Norge

Awarded: NOK 10.3 mill.

From spring 2022, one shared electronic health record (the Health Platform) will be introduced for all health personnel (hospitals, municipalities, GPs and private specialists), as well as for the inhabitants of Central Norway. St Olav's hospital and Trondheim municipality are first out, followed by Helse Nord-Trøndelag in the autumn of 2022, and Helse Møre og Romsdal in the spring of 2023. The health record system is delivered by the American supplier Epic, and goes by the name Helseplattformen in Norway. The implementation is the largest and most expensive implementation of a health information system (HIS) ever in Norway, and currently no systematic research is conducted to learn from the implementation. This project aims to fill this knowledge gap. REAL's overall aim is to expand the knowledge base on the implementation of large-scale HIS. Objectives are (i) to develop knowledge on the dynamics between healthcare services (users), the implementation organisation (Health Platform), and the vendor (Epic) in the shaping and execution of the implementation projects, (ii) develop knowledge on the healthcare services' preparations, work processes, and early use and adaptations of Epic, (iii) provide research-based feedback to the healthcare services and the Health Platform organisation so they can adjust the implementation process accordingly, and to (iv) contribute to concept and development for large-scale EHR implementations in healthcare. REAL has a multi-site qualitative design and we will investigate the implementation process in the three health trusts in Central Norway, as well as how the Health Platform works as an implementation organization. We will use participant observation and interviews as research methods. In addition, documents describing the implementation process will form part of the data. Knowledge exchange between researchers, practitioners, and decision-makers will take place through workshops and lectures, and results will be disseminated through a website, a podcast, and though standard scientific publications, i.e., journal articles and conference presentations. Academic partners: SINTEF (project manager), Norwegian University of Science and Technology, UiT The Arctic University of Norway, the Norwegian Centre for eHealth Research, and the University of Copenhagen. Project partners: The Health Platform, St. Olavs hospital/health trust, Nord-Trøndelag health Trust, Møre & Romsdal Health Trust. The project started September 1st 2021, and as of November 2021, the work has been about establishing a good project structure and establishing agreements with the partners. Researchers from REAL also participate in the Health Platform's monthly meeting for researchers, where researchers and employees in the Health Platform mutually update each other. We also had a kick off meeting on November 16th 2021 with all the partners. The position as PhD candidate has been advertised with a deadline of early December 2021.

One shared electronic health record (EHR) for all healthcare providers (hospitals, municipalities, general practitioners, and private providers, and citizens) will be implemented in Central Norway from spring 2022. It is the largest and most expensive implementation of a health information system (HIS) ever in Norway, and currently no systematic research is conducted to learn from the implementation. The REAL project aims to fill this knowledge gap. Large-scale implementations are extremely expensive, disruptive for staff, and the realisation of benefits may be questioned. However, conducted the right way, an implementation can be a step towards organisational transformations and an improved outcome. In REAL researchers and healthcare organisations work together to learn about the implementation, and researchers will provide guidance to the implementing organisations. The overall aim is to expand the knowledge base on implementing large-scale HIS. Objectives are (i) to develop knowledge on the dynamics between healthcare services (users), the implementation organisation (Health Platform), and the vendor (Epic) in the shaping and execution of the implementation projects, (ii) develop knowledge on the healthcare services' preparations, work processes, and early use and adaptations of Epic and the organisation of work, (iii) provide research-based feedback to the healthcare services and the Health Platform organisation so they can adjust the implementation process accordingly, (iv) develop fora (website, workshops and lectures) for regular contact and knowledge exchange between researchers, practitioners, and policy makers, and to (v) contribute to concept and development for large-scale EHR implementations in healthcare REAL has a multi-site qualitative design and will investigate the implementation process in six sites (hospitals and municipalities), allowing us to compare and explore similarities and variations.

Funding scheme:

HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester