The organizing vision of integrated health information systems

TL;DR

This paper explores the ambiguous concept of integration in health information systems, analyzing how its flexible interpretation supports stakeholder support and examining the evolution of integration visions through a case study at a Norwegian university hospital.

Contribution

It clarifies the multiple meanings of integration in health information systems and investigates how these meanings evolve during implementation to garner stakeholder support.

Findings

Integration has multiple meanings, from technical to service-oriented.

Ambiguity in integration helps mobilize political and stakeholder support.

The vision of integration evolves through technological and conceptual changes.

Abstract

The notion of integration in the context of health information systems is ill-defined yet in wide-spread use. We identify a variety of meanings spanning from purely technical integration of information systems to integration of services. This ambiguity (or interpretative flexibility), we argue, is inherent rather accidental: it a necessary prerequisite for mobilising political and ideological support among stakeholders for integrated health information systems. Building on this, our aim is to trace out the career dynamics of the vision of integration/ integrated. The career dynamics is the transformation of both the imagery and material (technological) realisations of the unfolding implementation of the vision of integrated care. Empirically we draw on a large, ongoing project at the University hospital of North Norway (UNN) to establish an integrated health information system