Nothing Free About Free Market

Abstract

This section sheds light on the effects of the different strategies that Norwegian authorities have adopted to enroll users and vendors in the task of establishing electronic prescriptions as a new national routine service. The case description highlights how stakeholders responded when the authorities needed integration between the new service and the information systems that physicians use in their daily work, namely the electronic patient record (EPR). The strategy that focused mainly on the vendors made it difficult to mobilize the users and the authorities staged themselves as the “real” customers of the project. An integration unit that the authorities developed was not embedded robustly with the existing infrastructure. The EPR is the most important information system that the health care institution uses and through the years this system has evolved to its improved current standard. In a country like Norway, with very few vendors, the EPR market is a very small and dedicated one. Any influence of this market from a powerful vendor, like the authorities, will affect the market in a significant way. The authorities that play a role in this market should not underestimate the negative effect that might result from a change in the EPRs’ functionality, even if the intentions are solely positive for all stakeholders.