Abstract

Public sector IT projects have to contend with challenges that go beyond socio-technological hindrances, and which relate to issues regarding bureaucracy, efficiency and budgeting as well. This complexity is compounded when situated in a healthcare context, given the known challenges of appropriate use of IT in this area. This paper employs Swanson and Ramiller’s (1997) concept of organizing visions to investigate the discourse surrounding electronic health records in England. We illustrate how the organising vision of electronic health records was apparent in England’s National Programme for IT (NPfIT), highlighting its shifting priorities and the variations across the stakeholder groups involved in the project. Recognising the presence of conflicting as well as converging dynamics between these actors, we build on research which has discussed the differences between collective groups such as clinicians, IT developers and managers. We discuss the shifting roles of community groups specific to the NPfIT organizing vision and draw from literature on professional hybridization to illustrate the existing overlap between clinicians and IT professionals, a hybrid form which has seen limited research to date.

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