||Without IT most health care organisations would collapse. IT is for example used in medical devices, during surgeries, for documenting information about the patients, communication between different care providers, in research towards improved treatments. This thesis is about health IT usage in practice. It is about improving the IT systems and usages so the IT systems are working as a supportive tool for the care providers in practice. The health care organisation is complex since it consists of heterogeneous groups of people (clinical professions, patients, managers), technology (medical devices and patient record systems) and organisational and clinical routines. In this thesis a sociotechnical approach is used, which means that all these factors are considered to affect the health IT deployment and usage.
Within the ehealth community a trend towards consistency can be seen. This has the affect that care organisations are implementing enterprise-wide system solutions. The benefits with enterprise systems are that sharing data is easier, however complaints about the risks with the systems can be heard from the health professionals. They often consider the systems to be to generic and require them to change their practice to the process that the system is based on. This thesis is about gaining knowledge about how to create a supportive, efficient tool when an enterprise-wide health IT solution is used. The research is based in a longitudinal research study with a Swedish county that have implemented a region-wide electronic patient record system (EPR).
The research presented in this thesis has its starting point in a 2,5 years (2008-2010) longitudinal research project together with a Swedish county that are responsible for both primary and hospital care. The participating county had a couple of years before the research study started procured and implemented/deployed a region-wide EPR system through out all hospital units and primary care organisations. The primary goal with the research project was to study the organisationsí IT situation with regard to usability issues and make suggestions that could lead to changes in how to work more effectively with the IT systems.