Building nation-wide information infrastructures in healthcare through modular implementation strategies

Aanestad, Margunn; Jensen, Tina Blegind

doi:10.1016/j.jsis.2011.03.006

Cited by 162 publications

(173 citation statements)

References 21 publications

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“…It is fascinating to see how the collaboration among different stakeholders made it possible to integrate divergent priorities and strategies into one shared portal. This conclusion is in line with previous research (e.g., Aanestad and Jensen 2011), which shows that the realization of nation-wide information infrastructures for healthcare not only requires a gradual transition of the installed base; the development also needs to ensure the mobilization and organization of multiple stakeholders.…”

Section: Discussion: Moving Forwardsupporting

confidence: 92%

“…Initially, SUP provided a majority of hospitals and GPs across Denmark with the possibility of accessing electronic health records across counties. Extracts of patient data are transferred via a nationwide MedCom XML standard to a SUP database/ Internet server, where an Internet browser provides access for healthcare professionals to view selected patient information and record data by searching on the patient's civil registry number (Aanestad and Jensen 2011;Jensen 2013). The head of administration at sundhed.dk explained: "We have 'buttoned on' services and applications over time […]…”

Section: Collate and Assemble Existing Data Resourcesmentioning

confidence: 99%

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Building National Healthcare Infrastructure: The Case of the Danish e-Health Portal

Jensen

Thorseng

2017

Health Informatics

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Sundhed.dk facilitates patient-oriented digital services which provide access to and information about the Danish healthcare services. Since its launch in 2003, sundhed.dk provides several functionalities such as quality assured health information, access to medical records and medication, and an overview of the Danish healthcare system. Sundhed.dk creates linkages between existing data sources, opens up data sets to new user groups, and facilitates communication between healthcare providers and citizens. The portal also ensures further development not only by providing a secure infrastructure, search optimization, and user interfaces, but also by supporting the development of new services.Sundhed.dk has earned good reputation and high standing in the healthcare sector internationally. Health authorities from other countries, that wish to build similar solutions, have approached sundhed.dk for advice and best practice (Sundhed.dk 2014a). However, the positive reputation and high level of maturity of sundhed.dk has not been established overnight. Thus the assumption by other countries of simply copying the code, the user interface, and the technical infrastructure is far too simplistic if they wish to attain what Denmark has achieved with respect to e-health services for citizens. Other infrastructural resources in place, including existing systems, regulations, communication standards, as well as organizational structures in the Danish healthcare sector, have played a vital role in establishing the national 210 e-health infrastructure (Thorseng and Jensen 2015). Consequently, the design, development, and implementation of an e-health initiative such as sundhed.dk, that has become an integrated part of a national infrastructure, becomes relevant to study.In line with the aim of the book, this case chapter provides insights into the role of the installed base -i.e., pre-existing technologies, regulatory frameworks, data resources, and organizational arrangements -in the evolution of sundhed. dk. In particular, we argue that the main reasons for the current positioning of sundhed.dk have been its ability to (1) collate and assemble existing data resources, (2) repurpose and enhance current data sources in the health sector, and (3) engage a multiplicity of stakeholders. We argue that these activities represent three ways of capitalizing on the installed base that has led to the evolution and current situation of the e-health portal. At the same time, we show how these three modes come with a number of challenges for sundhed.dk in its pursuit of further innovation.The rest of the chapter is organized as follows. We start out by introducing the Danish healthcare sector to set the context for sundhed.dk. Further, we describe the development of sundhed.dk, its purpose, as well as its current organization. Based on this description, we analyze how the organization behind the e-health portal succeeded in establishing a national healthcare infrastructure by assembling existing data resources, repurposing current healthcar...

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Section: Discussion: Moving Forwardsupporting

confidence: 92%

Section: Collate and Assemble Existing Data Resourcesmentioning

confidence: 99%

Building National Healthcare Infrastructure: The Case of the Danish e-Health Portal

Jensen

Thorseng

2017

Health Informatics

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“…This seems to be a prudent strategy. Prior information infrastructures' literature has indicated that the successful development of information infrastructures such as the Internet, mobile phone platforms and healthcare-specific arrangements has been achieved by following similar strategies (Hanseth and Lyytinen 2010;Aanestad and Jensen 2011;Aanestad and Hanseth 2002). Our findings are specific to processes for advancing the development of infrastructures that are already in place, nevertheless, they are congruent with recent findings by Grisot et al (2014) that identified three different types of infrastructure innovation: in, of, on infrastructures.…”

Section: Discussionmentioning

confidence: 99%

The Norwegian eHealth Platform: Development Through Cultivation Strategies and Incremental Changes

Grisot

Vassilakopoulou

Aanestad

2017

Information Infrastructures Within European Health Care

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This chapter presents the approach followed for the development of the Norwegian national solution for patient-oriented eHealth services (here called HealthNorway). Our research interest is twofold: first, on understanding the initial design decisions and initial evolution in relation to the installed base of existing digital capabilities, and, second, on understanding how HealthNorway was further developed after the initial launch in relation to the long term vision of offering comprehensive and readily available health services to citizens. Drawing from the case, we identify different approaches for infrastructural development in the form of proactive cultivation strategies related to extending, complementing and creating substitutes within the installed base.The remainder of the chapter is structured as follows: we provide first a brief overview of the Norwegian health system and its digital infrastructure; we then introduce our case and present key activities, concerns and decisions for HealthNorway

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“…All successful infrastructures started small and evolved into large ones. Approaches for growing an infrastructure from an initial setup solving a very specific problem for a minor group of stakeholder, to a more generic solution that is adopted by a larger group of users include the creation of an 'attractor' (Braa, Macome et al 2001), adherence to design principles that enable growth (Hanseth & Lyytinen, 2010), incremental functional deployment (Aanestad and Jensen 2011), promotion of generative evolutionary mechanisms (Henfridsson & Bygstad, 2013) and the establishment of 'killer apps' (Eaton et al, 2014) for the active management of the growth of the installed base.…”

Section: Digital Infrastructure Designmentioning

confidence: 99%

The Anatomy of Digital Trade Infrastructures

Rukanova

Henriksen

Henningsson

et al. 2017

Lecture Notes in Business Information Processing

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Building nation-wide information infrastructures in healthcare through modular implementation strategies

Cited by 162 publications

References 21 publications

Building National Healthcare Infrastructure: The Case of the Danish e-Health Portal

Building National Healthcare Infrastructure: The Case of the Danish e-Health Portal

The Norwegian eHealth Platform: Development Through Cultivation Strategies and Incremental Changes

The Anatomy of Digital Trade Infrastructures

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