TRANSFORMING A HOSPITAL THROUGH GROWING, NOT BUILDING, AN ELECTRONIC PATIENT RECORD SYSTEM

The benefits for any health care provider of successfully introducing an Electronic Patient Record System (EPRS) into their organisation can be considerable. It has the potential to enhance both clinical care a nd managerial processes, as well as producing more cost-effective care and care programmes across clinical disciplines and health care secto rs. However, realising an EPRS's full potential can be a long and diff icult process and should not be entered into lightly. Introducing an E PR System involves major personnel, organisational and technological c hanges. These changes must be interwoven and symbiotic and must be man aged so that they grow together in stages towards a vision created and shared by all clinical professional staff, other staff, and managers in that process. The use of traditional ''building'' or ''journey'' me taphors inadequately reflects the complexity, uncertainty and, therefo re, the unpredictability of the process. We propose that a more useful metaphor may be of ''growing'' a progressively more united, unified i nformation system and health care organisation. We suggest this metaph or better recognises that the evolutionary process appears to be more organic than predictable and more systemic than mechanistic. An illust ration is given of how these organisational clinical and technical iss ues might evolve and interweave in a hospital setting through a number of stages.