Why is it so hard to set up systems for sharing electronic health records? A framework for investigating complex sociotechnical change
Governments and private companies around the world have spent millions of dollars attempting to establish electronic systems for sharing individual health records. Although technologically feasible, they have been very difficult to implement because of political, cultural and legal complexities. In this paper, we develop a theoretical framework for investigating attempts to build and implement electronic health record systems that draws on the work of practice theorist Laurent Thévenot and health policy analyst Jenny Lewis. We use data from a pilot study of two electronic health record projects to illustrate how the framework can be used to analyse complex sociotechnical innovations that span organisational and professional boundaries.