title: Big is beautiful: electronic patient records in large Norwegian hospitals 1980s-2001.
abstract: OBJECTIVE
  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.
authors.affiliation: University Hospital of Northern Norway, 9038 Breivika, Norway. gunnar.ellingsen@unn.no
authors.forename: G
authors.initials: G
authors.lastname: Ellingsen
authors.forename: E
authors.initials: E
authors.lastname: Monteiro
mesh_terms: D004059:Diffusion of Innovation; D018166:Health Care Reform; D006751:Hospital Information Systems / Q000458:organization & administration* / Q000639:trends; D006785:Hospitals, University / Q000458:organization & administration* / Q000639:trends; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration* / Q000639:trends; D009664:Norway; D016730:Program Development