Start Date

11-12-2016 12:00 AM

Description

In this paper we investigate tensions in large e-health infrastructure programs. Currently, there is a gap between the large expectations to e-health and the fragmented status of IT services. In response to this situation the health authorities in many countries has called for a strategy of central IT governance and enterprise architecture. However, many large programs experience tensions, leading to failures. Our research question is, how can we understand and manage the tensions of large-scale programmes in e-health? The empirical evidence is a multilevel study of a national e-health Norway initiative, at three levels; national, regional and project. We find that the governance-architecture approach is not effective in balancing the tensions of e-health infrastructures. Our proposed solution is to differentiate between stable and unstable elements of the infrastructure; the stable elements should be designed and managed top-down, while the unstable elements should be subject to local innovation and decentralised governance.

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Dec 11th, 12:00 AM

Governing e-Health Infrastructures: Dealing with Tensions

In this paper we investigate tensions in large e-health infrastructure programs. Currently, there is a gap between the large expectations to e-health and the fragmented status of IT services. In response to this situation the health authorities in many countries has called for a strategy of central IT governance and enterprise architecture. However, many large programs experience tensions, leading to failures. Our research question is, how can we understand and manage the tensions of large-scale programmes in e-health? The empirical evidence is a multilevel study of a national e-health Norway initiative, at three levels; national, regional and project. We find that the governance-architecture approach is not effective in balancing the tensions of e-health infrastructures. Our proposed solution is to differentiate between stable and unstable elements of the infrastructure; the stable elements should be designed and managed top-down, while the unstable elements should be subject to local innovation and decentralised governance.