The impact of clinical management on implementation of a structured Electronic Health Record


Many Information and Communication Technology (ICT) implementations fail to deliver expected organizational benefits. In healthcare, ICT and organization are closely related and dependent on each other. Introducing new technology requires change in established work routines and organizational practices. However, empirical evidence suggests that socio-technical challenges are frequently overlooked when implementing new technology in healthcare. This is a formative research project focused on the implementation of two interdependent ICT solutions in the FRESK-program, and addresses the challenges related to change management when implementing a region-wide Electronic Health Record and structured data elements.

Increased and complex digitalization forces a need for a new type of role and competency for clinical managers. At both the national and regional level, strategies for how technology should be utilized in care delivery are described alongside expected benefits and outcomes. Actual outcomes and realized benefits are, however, dependent on effective implementation and change management. It is therefore important to develop new knowledge and methods for effective implementation and change management strategies to ensure that the expected outcome is fulfilled.


The aim of the proposed PhD research project is to develop theoretically informed guidelines and strategies for how clinical managers in the hospital should be engaged in a regional ICT implementation process:

  1. defining and anchoring expected goals
  2. leading change management in the organization
  3. ensure realization of the goals


This is a formative research project focused on the implementation of two interdependent ICT solutions. Our primary tool for data collection will be individual semi-structured interviews, observations and focus group interviews, in addition to document reviews. The project addresses challenges in large-scale EHRs by investigating both the prerequisites and strategies at the executive level; the expectations and implementation feasibility at the department managerial level; and the motivation and perceived usability at the end-user level.


In the long-term, this research will provide knowledge about the new, emerging role of clinical managers and transferable guidelines for change management in ICT implementations. Effective change management is identified as a key component for realizing expected benefits from new technology. In addition, the research will deliver positive short-term effects to the ongoing ICT implementations in the NN-RHA through a close collaboration with the relevant stakeholders.