The Implementation of an Electronic Health Record: Comparing Preparations for Epic in Norway with Experiences from the UK and Denmark

Background: The implementation of electronic health records (EHRs) requires careful preparations but may still cause trouble. In this study we focus on one EHR - Epic.

Purpose: We compare the experiences from implementing Epic in the UK and Denmark with the preparations for implementing it in Norway.

Method: The study is based on document analysis (UK and Denmark) and interviews (Norway).

Results: Epic had a troubled start in both the UK and Denmark with malfunctions in the interfaces to other clinical systems, disruptions in the continuity of care, and drops in performance. While the state of routine use has subsequently been reached in the UK, the transition process is still ongoing in Denmark. In Norway experiences from, especially, Denmark are heeded in planning the implementation of Epic, which is expected to deliver better care more efficiently. We discuss six pitfalls to achieving these benefits.

Conclusion: Experiences from, especially, Denmark inform the Norwegian preparations, but these experiences point toward more challenges than solutions. The implementation of Epic in Norway is currently in a state of considerable uncertainty.