The Failed Implementation of the Electronic Prescription in Germany - A Case Study

Many countries worldwide are striving for improving the quality of care and for reducing costs in the health care sector by establishing large IT infrastructures. In Germany, the introduction of the electronic health card and the national telematics infrastructure is lagging years behind the original schedule. In this paper, we describe and analyze a case study of one selected part of this ultra-large intervention. The selected part is the failed implementation of the electronic prescription. The related activities started in 2003 and ended in 2010 when a decision was made to abandon this part of the intervention. We present a detailed analysis of the project and identify 14 reasons in five categories for the project’s failure. Furthermore, we provide a multi-layered overview of the episodes and sub-projects

Enterprise Architects’ Logics across Organizational Levels: A Case Study in the Norwegian Hospital Sector

In this paper, we report about a multilevel case study on the introduction of enterprise architecture (EA) in the Norwegian hospital sector. We utilize institutional logics as a theoretical lens, focusing on the enterprise architects’ logics that are underexplored in information systems research. We have col-lected empirical evidence at national (macro), regional (meso), and local (micro) levels. The findings are classified into nine categories with illustrative statements from the informants, demonstrating their reasoning about the contributions of EA. Furthermore, we identify tensions between enterprise archi-tects and managers and between enterprise architects and medical actors, which indicate the co-existence of multiple competing institutional logics. The most prominent tension is the paradox of EA—demands for local flexibility and autonomy at the micro level versus the predefined rules and standardization that EA imposes across all levels—which makes the institutionalizing process chal-lenging. The enterprise architect logics demonstrate similarities and differences across the various levels, indicating heterogeneity. We conclude this paper with a suggested persona of the enterprise architect, which illustrates the empirical findings

Why e-government projects fail: main antecedents of the non-adoption of electronic health records in Germany according to stakeholder perceptions

The Electronic Health Record in Germany was introduced in January 2021 and offers the integrated use of the application across sectors and institutions. However, two years after this introduction, less than 1% of the German population has applied for such a record with their health insurance provider. This is despite evident support of medical professionals as well as the society at large. To explain this non-adoption in particular and e-government non-adoption in general, the main goal of this thesis is the synthesis of the main antecedents of e-government non-adoption by investigating the perceptions of its main stakeholders: political stakeholders, medical professionals and citizens. Building on the assumption that non-adoption is not simply the opposite of adoption, and that perceptions of stakeholders play a crucial role in the engagement with e-government, this study is set in an interpretive, single case study. Moreover, the research conducted in this thesis employs Q-methodology, a mixed-methods approach that allows for the study of subjective experiences, and therefore perceptions. Analyzing the data from 29 participants (4 political stakeholders, 9 medical professionals and 16 citizens), this study found four main antecedents of non-adoption: communication, trust, design and attitude. These can be considered a starting point for more research focused explicitly on non-adoption and give valuable insights for practitioners