eHealth and IT in Network Healthcare : Threats and Opportunities

Abstract: Stockholm's healthcare system faces increasing strains on its resources. In order to address these issues, the Stockholm county council has devised a plan for future healthcare, as well as a strategy for IT to accompany this future vision. This master’s thesis investigates inhibitors and facilitators facing this IT-strategy and subsequently evaluates its efficacy based on interviews with individuals with extensive knowledge of Health IT in Sweden. This study employs a holistic and socio-technical perspective on eHealth and healthcare IT, regarding the object of study as an information infrastructure. Defining eHealth in the interview study proved to be a dubious task and is suggestive of a potential inhibitor for the IT-strategy. The study has located the facilitators and inhibitors in three domains: the sociotechnical, institutional and within how healthcare, patients and healthcare professionals are constituted. Important facilitators include stakeholder involvement, where the more engaged citizen is a promising resource. Certain design choices, an appropriate innovation support structure as well as a close attention to work practice development could facilitate the achievement of the goals in the strategy. Many aspects of the institutional environment are potential inhibitors. The strategy for implementation was found to be vague and is thus regarded as difficult to properly evaluate, apply, and follow-up. Furthermore, it is not evident from the way it is phrased what role citizens will have in the development process. While work practice development is mentioned as a substrategy, the corresponding implementation strategy needs elaboration in order to ensure that this aspect is accounted for. In light of the interviewee’s discussion on interoperability, the potential attributed to the Service Platform in the implementation strategy seems overestimated.