Healthcare delivery in the northern periphery of Europe is challenged by dispersed populations, geographical complexities (including mountainous terrain and inhabited islands), ageing populations, and rising patient expectations. It is challenged further by variations in transport networks and information communication technology infrastructure. This article provides an overview of e-health development across the northern periphery areas of four northern European countries (Finland, Sweden, Norway, and Scotland) by summarizing the outcomes of a mixed methods e-health mapping exercise and subsequently identifying service needs and gaps. A total of 148 applications, with a range of applied e-health solutions, were identified and the findings have promoted the sharing and transfer of e-health innovation across the four countries. The supporting telecommunications infrastructure and development of innovative telemedicine appear slower in sparsely populated areas of Scotland in comparison to its northern peripheral counterparts. All four countries have, however, demonstrated a clear commitment to the development of e-health within their remote and rural regions.
This paper focuses on one of the first efforts to implement large-scale Electronic Patient Records (EPRs) in Western hospitals conforming to the international openEHR architecture. A key aim with the openEHR architecture is to offer clinical users the possibility to define structured content of the EPR themselves. This is supposed to contribute to interoperability across various health care systems. The paper contributes with empirical insight in the first two years of the process and argues that establishing working systems in this area entails huge socio-technical challenges to make such systems work.
We report from a large-scale Electronic Patient Record (EPR) project in Northern Norway where the goal is to design a new type of configurable EPRs that allow users in hospitals to tailor the software to their specific needs. This ability appears to challenge the traditional user role as what we usually understand as ordinary users increasingly undertake a designer role, hence dissolving the boundaries between users and designers. Still, the configurability of the software is not straightforward as it is not obvious who is going to decide how the final design should look like, how much tailoring should be possible and in which situations.
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