IT-enabled healthcare integration: The case of national electronic health records in Singapore

Information Technology (IT) is considered as an important enabler towards achieving integrated health care. Consequently, Electronic Health Record (EHR) systems, which serve as the foundation for integrated care across organizations, regions, or nations, have received much attention globally. However, many EHR systems have failed to be implemented successfully. The buy-in of different stakeholders has been identified as an important factor to smoothen the IT healthcare integration process. By employing stakeholder and institutional theories as theoretical lenses to examine the influence of different stakeholders in EHR implementation, we aim to form a deeper understanding of how EHR initiatives can be managed for healthcare integration. A positivist, exploratory, case study approach was chosen to analyze the till date successful implementation of the National Electronic Health Record (NEHR) initiative in Singapore. Based on both primary and secondary data, we report preliminary findings about the salience and institutional influences for key stakeholders in this context. This study contributes to research by extending stakeholder theory through including the dynamic view of institutional theory. Moreover, it can provide practictioners with insights to implement EHR programs for healthcare integration effectively.