Panel: From policy to practice: Achieving nation-wide information systems in healthcare.

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19th European Conference on Information Systems, Helsinki 2011 1

FROM POLICY TO PRACTICE: DEFINING REALISTIC
TRANSITION STRATEGIES FOR ACHIEVING NATION-WIDE
INFORMATION SYSTEMS IN HEALTHCARE


Chair:

Panelists: Wendy Currie, Fellowship of Postgraduate Medicine, UK (wendy.currie@fpm-uk.org)
Tina Blegind Jensen, Copenhagen Business School, Denmark (tbj.inf@cbs.dk)
Margunn Aanestad, University of Oslo, Norway (margunn@ifi.uio.no)
Ton A.M. Spil, University of Twente, the Netherlands (a.a.m.spil@utwente.nl)
Nancy Pouloudi, Athens University of Economics and Business (pouloudi@aueb.gr)
[awaiting final confirmation]


Summary
The underlying premise of the panel is that it requires a serious effort to define realistic transition
strategies for achieving national programs for information systems (IS) in healthcare. The advancement
of large-scale IS initiatives in the healthcare sector offers a number of opportunities in terms of
improvements of quality in treatment and care, interoperability, as well as productivity at a lower cost. At
the same time, however, policy-makers and practitioners face a number of challenges that relate not only
to technical issues of interoperability, data security, and confidentiality but also to social, organizational,
and regulatory elements. The panel “From Policy to Practice: Defining Realistic Transition Strategies
for Achieving Nation-Wide Information Systems in Healthcare” addresses the challenges of achieving
national healthcare systems that are more prosperous, sustainable and serve all through the utilization of
IS, with the aim of helping practitioners and decision-makers translate large-scale IS policies into
practice. Based on experiences from five European countries, the panelists will present large-scale IS
healthcare initiatives to engage a discussion. While the statements presented by the panelists mainly
pertain to a healthcare context, we aspire to transform the discussion into a sustainable discourse that
will serve the community of IS researchers and practitioners at large.

Background and Aspirations
A considerable amount of resources is directed by governments and healthcare providers towards
achieving nation-wide, fully integrated healthcare infrastructures (Coiera 2009). For example in the UK,
the implementation of a National Program for IT has been estimated to cost £12.4 billion over 10 years
(House of Commons 2007). Similarly in the United States, a new health information infrastructure that
connects EPR systems via a Nation-wide Health Information Network throughout both the public and
private sectors is envisioned (Office of the National Coordinator 2008).
While the vision of achieving nation-wide health information infrastructures has been long-standing in
many countries, it has yet to be realized (Currie and Guah 2007; Jones 2004). There seems to be a broad
agreement between policy-makers, providers, and patients about the benefits of integrated information
systems (IS) in healthcare; however, there is much less consensus about how to translate large-scale
eHealth policies into practice (Jensen and Aanestad 2010). Health policy-makers and providers in Europe
and beyond are faced with an endless list of questions such as: How to build on the installed base of

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existing technologies already invested in? How to ensure interoperability between different systems? How
to define realistic transition strategies, i.e. how to realize visions? How to ensure that eHealth
technologies correspond to the needs of the actors involved and thus provide immediate benefits? In sum:
How to address the apparent gap that exists between policy and practice?
Building on the presupposition that IS matters to organizations and their stakeholders in healthcare, and
that IS both supports and leads to improved healthcare services (Hanseth and Aanestad 2003), we bring
together leading scholars to discuss these questions on how to advance IS innovation with the objective of
obtaining a healthcare system that is more prosperous, ecologically healthy, and serves all. Based on
experiences from five European countries, the panelists will address the contribution and role of IS in
healthcare and critically reflect upon the challenges that are encountered within this sector.
The aim of this panel is to provide a strong foundation for presentation and discussion of research and
empirical examples to highlight issues related to technical, organizational, political, social, managerial
and socioeconomic aspects of IS related issues in the healthcare sector. Based on the inputs from the
panelists, we wish to open up a debate with the audience on ways to bridge policy and practice. We turn
our attention to transformational change to emphasize a future state of healthcare which is not clear at the
beginning and consequently where the process for “getting there” cannot be clear either. Furthermore, this
terminology points to a future state that is so radically different from the current one that a shift of
mindset is required to invent it, let alone implement and sustain it. In this framework, health policy-
makers, providers, and patients must transform their mindsets, behavior, and ways of working together.
With an emphasis on the healthcare related issues being raised above, the panel will examine core issues
on how to translate large-scale IS policies in healthcare into practice. Panelists will:
• define and discuss the relevance and possible implications of large-scale IS initiatives in
healthcare
• highlight issues related to technical, organizational, political, social, managerial and
socioeconomic aspects of IS healthcare initiatives
• discuss the complex, unpredictable, and uncontrollable nature of large-scale IS initiatives in
healthcare
• discuss whether the role of government should simply be to set the policy rules or also to engage
in the process of IS implementation
• draw on best practice examples and lessons learned from five European countries to suggest ways
of using IS for providing leverage and fulfilling goals in the healthcare sectors all over the world
• suggest avenues of future IS-related research which takes a stand in relation to large-scale IS
initiatives in healthcare
The panel is to be considered as a driver, enabler, and motivator for people who share both deep insights
in IS research and a passion for healthcare related issues. Although the discussions will pertain to a
healthcare context, we aspire to transform the discussion in the ECIS panel into a sustainable discourse
that will serve the community of IS researchers and practitioners at large. At minimum, we hope that the
panel will stimulate new thinking about the role IS as mobilizer of innovation and transformations in
healthcare and other sectors.
Panel Format
The panel is designed to touch upon present and future challenges in the healthcare sector. Aligned with
the conference theme – ICT and Sustainable Service Development – the panelists will present large-scale
IS healthcare initiatives from five European countries to engage a discussion on how to develop and

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design sustainable service improvement in the healthcare sector. This issue will be presented from both an
academic and practice-based position, as follows:
Tina Blegind Jensen: Will provide a panel overview, rationale and aspirations. Based on a case study in
the Danish healthcare sector, where a problem-solving local solution helped
hospitals exchange data between existing Electronic Patient Record systems, she
will discuss what a realistic transition strategy entails for achieving nation-wide
IS in healthcare.
Wendy Currie: Will discuss the policy and technology issues relating to healthcare in the
European Union. She will report on a two year study on eHealth in twelve
countries. This study has developed the TEMPEST model which incorporates 84
qualitative and quantitative indicators to evaluate eHealth adoption and diffusion
in both leader and laggard Member States. She will argue that introducing
eHealth is a complex and challenging activity where benefits and risks are often
poorly defined.
Margunn Aanestad: Will present an analysis of strategic initiatives within the Norwegian healthcare
sector and discuss both successful and unsuccessful approaches to deal with the
complexity stemming from the interaction between technical, social,
organizational, and regulatory elements.
Ton A.M. Spil: Will discuss the role of eHealth in the Netherlands when it comes to sustaining
healthcare in the future with more elderly people and less professionals. This is
not properly on the agenda of the Ministries of health and often seen as a
“headache point”. Business modeling and scenario strategies can help overcome
this headache and put eHealth nation-wide on the map. To achieve this, laws must
be changed, privacy has to be secured, and standards should be created, but most
importantly web 2.0 is the way forward.
Nancy Pouloudi: Will discuss IS initiatives in Greece to achieve a nation-wide information
infrastructure in the healthcare sector.

Each panelist will provide a short presentation (approx. 10-15 min each) based on country specific
examples and put forward topics for discussion and provocative thoughts to engage the audience (approx.
25 min discussion). The panel will be concluded by a 5 min summary by the panelists.
Panelists
Tina Blegind Jensen (chair)
Tina Blegind Jensen is Assistant Professor of Information Systems at Copenhagen Business School,
Denmark. Her research takes a social view of organizational and managerial issues in the context of the
implementation and use of information systems. She is particularly interested in studying the relationship
between people and technology in healthcare organisations with emphasis on sensemaking among users,
institutional structures, and the changes in the nature of work practices.
Wendy Currie (panelist)
Professor Wendy Currie is Director and Co-founder of the International Policy and Technology Research
Unit at Warwick Business School. She is currently on the editorial board of 10 scholarly journals. She
served as European, Middle East and Africa representative for the Association for Information Systems,
and was joint Conference Chair for the International Conference on Information Systems held in Arizona
in December 2009.

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Margunn Aanestad (panelist)
Margunn Aanestad is Associate Professor of Information Systems at the Department of Informatics,
University of Oslo, Norway. She has studied the introduction of ICTs in healthcare, with an emphasis on
how to deal with the interaction between technical, social, organizational, and regulatory elements.
Ton A.M. Spil (panelist)
Ton A.M. Spil is researcher on eHealth with a master degree in Computer Science and a PhD in
Management Studies. He is guest editor for JSIS and has edited two books on eHealth. He is track chair in
international conferences on eHealth (AMCIS, ECIS and HICSS). He published in major journals and
conferences on information strategy, business modeling and eHealth innovation.
Nancy Pouloudi (panelist)
Nancy Pouloudi is Associate Professor at the Department of Management Science and Technology at
Athens University of Economics and Business.
[awaiting final confirmation]

References
Coiera, E. (2009). Building a national health IT system from the middle out. Journal of the American
Medical Informatics Association 16(3), 271-273.
Currie, W.L., Guah, M.W. (2007). Conflicting institutional logics: a national programme for IT in the
organisational field of healthcare. Journal of Information Technology 22(3), 235-247.
Hanseth, O., Aanestad, M. (2003). Design as bootstrapping. On the evolution of ICT network in
healthcare. Methods of Information in Medicine 42, 385-391.
House of Commons (2007). Department of health: the national programme for IT. Twentieth report of
session 2006-2007, HC390, House of Commons, London, UK.
Jensen, T.B. & Aanestad, M. (2010). National initiatives to build healthcare information infrastructures.
The 5th Mediterranean Conference of Information Systems, Tel Aviv, Israel
Jones, M. (2004). Learning the lessons of history? Electronic records in the United Kingdom acute
hospitals, 1988-2002. Health Informatics Journal 10(4), 253-263.
Office of the National Coordinator (2008). The ONC-coordinated federal health information technology
strategic plan: 2008-2012: using the power of information technology to transform health and care,
The Office of the National Coordinator, June 3.