The Failed Implementation of the Electronic Prescription in Germany - A Case Study

Many countries worldwide are striving for improving the quality of care and for reducing costs in the health care sector by establishing large IT infrastructures. In Germany, the introduction of the electronic health card and the national telematics infrastructure is lagging years behind the original schedule. In this paper, we describe and analyze a case study of one selected part of this ultra-large intervention. The selected part is the failed implementation of the electronic prescription. The related activities started in 2003 and ended in 2010 when a decision was made to abandon this part of the intervention. We present a detailed analysis of the project and identify 14 reasons in five categories for the project’s failure. Furthermore, we provide a multi-layered overview of the episodes and subprojects.

[1]  Chris Sauer,et al.  Why information systems fail: a case study approach , 1993 .

[2]  Douglas C. Schmidt,et al.  Ultra-large-scale systems , 2006, OOPSLA '06.

[3]  Gabrielle Durepos Reassembling the Social: An Introduction to Actor‐Network‐Theory , 2008 .

[4]  L. Gustafsson,et al.  Physicians' perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system. , 2004, International journal of health care quality assurance incorporating Leadership in health services.

[5]  Juan Rodon A methodological and conceptual review of inter organizational information systems integration , 2006, ECIS.

[6]  David M. Kreps,et al.  IS success and failure: the problem of scale , 2007 .

[7]  B. Wee,et al.  Decision-making on mega-projects: Cost–benefit analysis, planning, and innovation , 2008 .

[8]  Glenn A. Bowen Document Analysis as a Qualitative Research Method , 2009 .

[9]  Jan Marco Leimeister,et al.  Integration of Patient Health Portals into the German Healthcare Telematics Infrastructure , 2009, AMCIS.

[10]  Sven Laumer,et al.  Research on information systems failures and successes: Status update and future directions , 2014, Information Systems Frontiers.

[11]  Douglas C. Schmidt,et al.  Ultra-Large-Scale Systems: The Software Challenge of the Future , 2006 .

[12]  A. Boonstra,et al.  The Limited Acceptance of an Electronic Prescription System by General Practitioners: Reasons and Practical Implications , 2004 .

[13]  Mark Britnell Accelerating innovation: the power of the crowd , 2012 .

[14]  Joan Antoni Pastor,et al.  Unravelling the dynamics of IOIS implementation: an actor-network study of an IOIS in the seaport of Barcelona , 2008, J. Inf. Technol..

[15]  Elke Baumann,et al.  Die elektronische Gesundheitskarte , 2005, physiopraxis.

[16]  Lauri Salmivalli Governing the Implementation of a Complex Information Systems Network: - The Case of Finnish Electronic Prescription , 2006 .

[17]  Oscar Tamburis,et al.  The LITIS Initiative: Measuring the Level of eHealth Adoption in the Italian Healthcare Trusts , 2011, Bled eConference.

[18]  Caroline Richmond,et al.  Predators and prey , 1992 .

[19]  Jan Marco Leimeister,et al.  Analysis of the Applications of the Electronic Health Card in Germany , 2009, Wirtschaftsinformatik.

[20]  Jan Marco Leimeister,et al.  Security Analysis of the German Healthcare Telematics , 2009, AMCIS.

[21]  Stephanie S. Barrett,et al.  Inter-Organization Information Sharing Systems , 1982, MIS Q..

[22]  T. Greenhalgh,et al.  Theorising big IT programmes in healthcare: strong structuration theory meets actor-network theory. , 2010, Social science & medicine.

[23]  Kalle Lyytinen,et al.  Information systems failures—a survey and classification of the empirical literature , 1988 .

[24]  Ingrid Schirmer,et al.  An Empirically Grounded Ontology for Analyzing IT-based Interventions in Business Ecosystems , 2014, AMCIS.

[25]  Dimitra I. Petrakaki,et al.  Technological affordances of risk and blame: the case of the electronic prescription service in England. , 2014, Sociology of health & illness.

[26]  Craig Standing,et al.  The Implementation of Electronic Health Records: A Two Country Comparison , 2011, Bled eConference.

[27]  Marco Iansiti,et al.  The Keystone Advantage: What the New Dynamics of Business Ecosystems Mean for Strategy, Innovation, and Sustainability , 2004 .

[28]  J. F. Moore,et al.  Predators and prey: a new ecology of competition. , 1993, Harvard business review.

[29]  Henry C. Lucas,et al.  Why information systems fail , 1975 .

[30]  Chris W. Clegg,et al.  ‘The biggest computer programme in the world…ever!’: time for a change in mindset? , 2007, J. Inf. Technol..

[31]  Tony Cornford,et al.  The evaluation of the electronic prescription service in primary care: interim report on the findings from the evaluation in early implementer sites , 2012 .

[32]  Terry Young,et al.  The Vision and Reality of 'Connecting For Health': Tensions, Opportunities, and Policy Implications of the UK National Programme , 2008, Commun. Assoc. Inf. Syst..

[33]  Ingrid Schirmer,et al.  From Enterprise Architecture to Business Ecosystem Architecture: Stages and Challenges for Extending Architectures beyond Organizational Boundaries , 2014, 2014 IEEE 18th International Enterprise Distributed Object Computing Conference Workshops and Demonstrations.

[34]  Phanish Puranam,et al.  The (Under) Performance of Mega-projects: A Meta-organizational Perspective , 2014 .