Seeing EMR Emergence through a Practice Lens: Implications for Smaller Healthcare Practices

The development of national healthcare information infrastructures, specifically of shared electronic medical records, has received considerable attention by academics and practitioners for some time now. In reviewing information infrastructure development cases, a project management lens is typically applied which evaluates such cases in terms of success and failure and derives prescriptive conclusions accordingly. In this paper, we propose practice theory as an alternative lens and ask: How does evolution and design of information infrastructures look differently when the unit of analysis is broadened in both the scale and scope dimension? We apply this lens to interpret the cases of healthcare information infrastructure development in Finland and England and find that significantly different new action possibilities arise when seen from a practice theory perspective. We conclude that these possibilities are especially promising in the quest to involve smaller healthcare practices in the development of shared electronic medical record systems.