{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:05:28Z","timestamp":1754157928061,"version":"3.41.2"},"reference-count":58,"publisher":"Emerald","issue":"3","license":[{"start":{"date-parts":[[2009,8,14]],"date-time":"2009-08-14T00:00:00Z","timestamp":1250208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,8,14]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-heading\">Purpose<\/jats:title><jats:p>The purpose of this paper is to evaluate electronic health record (EHR) initiatives at the national\/external level. Governments are investing large amounts of money in national EHR systems. These systems are socially and politically complex and a variety of stakeholders (e.g. at the individual, organisational or national level) have an interest in evaluating such systems from technical, economic or patient outcome perspectives. In cognisance of academic research in the area, this paper presents an approach which uses the perspective of one particular type of professional critic, the media, to identify issues and evaluate their impact at a national level.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Design\/methodology\/approach<\/jats:title><jats:p>The work is conducted using an established evaluation framework and formal content analysis of selected relevant articles from the quality press of three selected countries.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p>Different issues take prominence in centralised vs decentralised EHR approaches. In countries with a decentralised approach issues of standards and interoperability take the fore. Where there is a more centralised approach the media focus is more on project management, budgetary and financial aspects. In all coverage political and economic aspects are emphasised over technical or patient outcome issues.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>The paper represents the application of the content\u2010context\u2010process framework. It contributes to the information systems evaluation literature at the national\/external level.<\/jats:p><\/jats:sec>","DOI":"10.1108\/13287260910983605","type":"journal-article","created":{"date-parts":[[2009,10,5]],"date-time":"2009-10-05T10:55:14Z","timestamp":1254740114000},"page":"208-229","source":"Crossref","is-referenced-by-count":4,"title":["A media analysis approach to evaluating national health information infrastructure development"],"prefix":"10.1108","volume":"11","author":[{"given":"Sophie","family":"Cockcroft","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"140","reference":[{"key":"key2022012720401483200_b1","doi-asserted-by":"crossref","unstructured":"Ammenwerth, E. and De Keizer, N. (2005), \u201cAn inventory of evaluation studies of information technology in healthcare trends in evaluation research 1982\u20102002\u201d, Methods of Information in Medicine, Vol. 44 No. 1, pp. 44\u201056.","DOI":"10.1055\/s-0038-1633922"},{"key":"key2022012720401483200_b2","doi-asserted-by":"crossref","unstructured":"Carter, M. (2000), \u201cIntegrated electronic health records and patient privacy: possible benefits but real dangers: strategies to develop integrated electronic health records must address consumer concerns, not dismiss them with claims of the \u2018public good\u201d\u2019, Medical Journal of Australia, Vol. 172, pp. 28\u201030.","DOI":"10.5694\/j.1326-5377.2000.tb123875.x"},{"key":"key2022012720401483200_b3","doi-asserted-by":"crossref","unstructured":"Clegg, C. and Shepherd, C. (2007), \u201cThe biggest computer programme in the world \u2026\u2009 ever!: time for a change in mindset?\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 212\u201021.","DOI":"10.1057\/palgrave.jit.2000103"},{"key":"key2022012720401483200_b4","doi-asserted-by":"crossref","unstructured":"Coiera, E.W. (2007), \u201cLessons from the NHS National Programme for IT\u201d, Medical Journal of Australia, Vol. 186 No. 1, pp. 3\u20104.","DOI":"10.5694\/j.1326-5377.2007.tb00774.x"},{"key":"key2022012720401483200_b5","doi-asserted-by":"crossref","unstructured":"Connell, N.A.D. and Young, T.P. (2007), \u201cEvaluating healthcare information systems through an \u2018enterprise\u2019 perspective\u201d, Information and Management, Vol. 44 No. 4, pp. 433\u201040.","DOI":"10.1016\/j.im.2007.04.002"},{"key":"key2022012720401483200_b6","unstructured":"Cooper, R., Viller, S. and Burmeister, J. (2004), \u201cObservations in a maternity ward: usability considerations for EHRs in an interrupt driven environment\u201d, in Walduck, K., Cesnik, B. and Chu, S. (Eds), HIC 2004: Proceedings, Health Informatics Society of Australia, Brunswick East, Victoria, pp. 205\u201011."},{"key":"key2022012720401483200_b7","doi-asserted-by":"crossref","unstructured":"Cordella, A. (2007), \u201cE\u2010government: towards the e\u2010bureaucratic form?\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 265\u201074.","DOI":"10.1057\/palgrave.jit.2000105"},{"key":"key2022012720401483200_b8","doi-asserted-by":"crossref","unstructured":"Cornford, T., Doukidis, G.I. and Forster, D. (1994), \u201cExperience with structure, process and outcome framework for evaluating an information system\u201d, Omega International Journal of Management Science, Vol. 22 No. 5, pp. 491\u2010504.","DOI":"10.1016\/0305-0483(94)90030-2"},{"key":"key2022012720401483200_b9","unstructured":"Cornwall, A. (2002), \u201cElectronic health records: an International perspective\u201d, Health Issues, Vol. 73, pp. 19\u201023."},{"key":"key2022012720401483200_b10","doi-asserted-by":"crossref","unstructured":"Crompton, P. (2007), \u201cThe National programme for information technology an overview\u201d, Journal of Visual Communication in Medicine, Vol. 30 No. 2, pp. 72\u20107.","DOI":"10.1080\/17453050701496334"},{"key":"key2022012720401483200_b11","doi-asserted-by":"crossref","unstructured":"Currie, W.L. and Guah, M.W. (2006), \u201cIT\u2010enabled healthcare delivery: The UK National Health Service\u201d, Information Systems Management, Vol. 23 No. 2, pp. 7\u201022.","DOI":"10.1201\/1078.10580530\/45925.23.2.20060301\/92670.3"},{"key":"key2022012720401483200_b12","doi-asserted-by":"crossref","unstructured":"Currie, W.L. and Guah, M.W. (2007), \u201cConflicting institutional logics: a national programme for IT in the organisational field of healthcare\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 235\u201047.","DOI":"10.1057\/palgrave.jit.2000102"},{"key":"key2022012720401483200_b13","doi-asserted-by":"crossref","unstructured":"DeLone, W.H. and McLean, E.R. (2003), \u201cThe DeLone and McLean model of information systems success: a ten year update\u201d, Journal of Management Information Systems, Vol. 19 No. 4, pp. 9\u201030.","DOI":"10.1080\/07421222.2003.11045748"},{"key":"key2022012720401483200_b14","unstructured":"Detmar, D. and Steen, E. (2006), \u201cLearning from abroad: lessons and questions on personal health records for national policy\u201d, White Paper, AARP Public Policy Institute."},{"key":"key2022012720401483200_b15","doi-asserted-by":"crossref","unstructured":"Doherty, N.F. and King, M. (2001), \u201cAn investigation of the factors affecting the successful treatment of organisational issues in systems development projects\u201d, European Journal of Information Systems, Vol. 10 No. 3, pp. 147\u201060.","DOI":"10.1057\/palgrave.ejis.3000401"},{"key":"key2022012720401483200_b16","doi-asserted-by":"crossref","unstructured":"Eason, K. (2007), \u201cLocal sociotechnical system development in the NHS National Programme for Information Technology\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 257\u201064.","DOI":"10.1057\/palgrave.jit.2000101"},{"key":"key2022012720401483200_b17","unstructured":"E\u2010health Media (2006), \u201cAcademics call for NPfIT technical assessment\u201d, available at: www.e\u2010health\u2010insider.com\/news\/item.cfm?ID=1822 (accessed 12 January 2008)."},{"key":"key2022012720401483200_b18","doi-asserted-by":"crossref","unstructured":"Evans, M.G. and Kalra, D. (2005), \u201cHealthcare computer systems \u2013 global approaches\u201d, Lancet, Vol. 365 No. 9453, pp. 10\u201011.","DOI":"10.1016\/S0140-6736(04)17678-2"},{"key":"key2022012720401483200_b19","unstructured":"Factiva (2006), Dow Jones and Reuters, available at: www.factiva.com"},{"key":"key2022012720401483200_b20","unstructured":"Goodchild, A., Bird, L. and Hoylen, S. (2005), \u201cUsing complex system techniques to aid health software design\u201d, Health Informatics Conference."},{"key":"key2022012720401483200_b21","doi-asserted-by":"crossref","unstructured":"Grain, H. (2003), \u201cHealth information managers and electronic health records: the impact of e\u2010consent\u201d, Health Information Management Journal, Vol. 33 No. 3, pp. 84\u20108.","DOI":"10.1177\/183335830403300304"},{"key":"key2022012720401483200_b22","unstructured":"Griever, M. (2006), Dr Griever's EMR, available at: DrGriever.blogspot.com (accessed 15 January 2009)."},{"key":"key2022012720401483200_b23","doi-asserted-by":"crossref","unstructured":"Gururajan, R., Quaddus, M. and Xu, J. (2008), \u201cClinical usefulness of handheld wireless technology in healthcare: a cross\u2010national study of Australia and India\u201d, Journal of Systems and Information Technology, Vol. 10 No. 1, pp. 72\u201085.","DOI":"10.1108\/13287260810876902"},{"key":"key2022012720401483200_b24","doi-asserted-by":"crossref","unstructured":"Halamka, J., Osterland, C. and Safran, C. (1999), \u201cCareWebTM, a web\u2010based medical record for an integrated health care delivery system\u201d, International Journal of Medical Informatics, Vol. 54 No. 1, p. 1.","DOI":"10.1016\/S1386-5056(98)00095-1"},{"key":"key2022012720401483200_b25","unstructured":"HealthConnect (2006), About HealthConnect, available at: www.HealthConnect.gov.au\/about\/index.htm (accessed 1 May)."},{"key":"key2022012720401483200_b26","doi-asserted-by":"crossref","unstructured":"Hendy, J., Reeves, B.C., Fulop, N., Hutchings, A. and Masseria, C. (2005), \u201cChallenges to implementing the national programme for information technology (NPfIT): a qualitative study\u201d, British Medical Journal, Vol. 331 No. 7512, pp. 331\u20104B.","DOI":"10.1136\/bmj.331.7512.331"},{"key":"key2022012720401483200_b27","unstructured":"HISA (2007), Health Informatics Society of Australia Submission to the Boston Consulting Group NEHTA Review, available at: www.hisa.org.au\/files\/doc\/submission_to_BCG_NEHTA_Review_v4_Public_Release.pdf"},{"key":"key2022012720401483200_b28","doi-asserted-by":"crossref","unstructured":"Hovenga, E., Garde, S. and Heard, S. (2005), \u201cNursing constraint models for electronic health records: a vision for domain knowledge governance\u201d, International Journal of Medical Informatics Nursing Informatics special issue, Vol. 74 Nos 11\/12, pp. 886\u201098.","DOI":"10.1016\/j.ijmedinf.2005.07.013"},{"key":"key2022012720401483200_b29","doi-asserted-by":"crossref","unstructured":"Irani, Z. and Love, P.E.D. (2002), \u201cDeveloping a frame of reference for ex\u2010ante IT\/IS investment evaluation\u201d, European Journal of Information Systems, Vol. 11, pp. 74\u201082.","DOI":"10.1057\/palgrave.ejis.3000411"},{"key":"key2022012720401483200_b30","doi-asserted-by":"crossref","unstructured":"Jensen, T.B. and Aanestad, M. (2007), \u201cHow healthcare professionals \u2018make sense\u2019 of an electronic patient record adoption\u201d, Information Systems Management, Vol. 24 No. 1, pp. 29\u201042.","DOI":"10.1080\/10580530601036794"},{"key":"key2022012720401483200_b31","doi-asserted-by":"crossref","unstructured":"Kaplan, B. (2001), \u201cEvaluating informatics applications \u2013 some alternative approaches: theory, social interactionism, and call for methodological pluralism\u201d, International Journal of Medical Informatics, Vol. 64, pp. 39\u201056.","DOI":"10.1016\/S1386-5056(01)00184-8"},{"key":"key2022012720401483200_b32","doi-asserted-by":"crossref","unstructured":"Kaplan, B. and Shaw, N.T. (2004), \u201cFuture directions in evaluation research: people, organizational, and social issues\u201d, Methods of Information in Medicine, Vol. 43 No. 3, pp. 215\u201031.","DOI":"10.1055\/s-0038-1633862"},{"key":"key2022012720401483200_b33","doi-asserted-by":"crossref","unstructured":"Klecun, E. and Cornford, T. (2005), \u201cA critical approach to evaluation\u201d, European Journal of Information Systems, Vol. 14 No. 3, pp. 229\u201043.","DOI":"10.1057\/palgrave.ejis.3000540"},{"key":"key2022012720401483200_b34","doi-asserted-by":"crossref","unstructured":"Kurtz, C.F. and Snowden, D.J. (2003), \u201cThe new dynamics of strategy: sense\u2010making in a complex and complicated world\u201d, IBM Systems Journal, Vol. 42 No. 3, pp. 46\u201083.","DOI":"10.1147\/sj.423.0462"},{"key":"key2022012720401483200_b35","unstructured":"Manning, W. (2005), \u201cPrivacy and confidentiality in clinical data management systems: why you should guard the safe\u201d, available at: www.netreach.net\/wmanning\/cdm.htm"},{"key":"key2022012720401483200_b36","doi-asserted-by":"crossref","unstructured":"Mark, A.L. (2006a), \u201cNotes from a small Island: researching organisational behaviour in healthcare from a UK perspective\u201d, Journal of Organizational Behavior, Vol. 27 No. 7, pp. 851\u201067.","DOI":"10.1002\/job.414"},{"key":"key2022012720401483200_b37","doi-asserted-by":"crossref","unstructured":"Mark, A.L. (2007), \u201cModernising healthcare \u2013 is the NPfIT for purpose?\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 248\u201056.","DOI":"10.1057\/palgrave.jit.2000100"},{"key":"key2022012720401483200_b38","doi-asserted-by":"crossref","unstructured":"Pagliari, C. (2005), \u201cImplementing the National Programme for IT: what can we learn from the Scottish experience?\u201d, Informatics in Primary Care, Vol. 13 No. 2, pp. 105\u201011.","DOI":"10.14236\/jhi.v13i2.587"},{"key":"key2022012720401483200_b39","doi-asserted-by":"crossref","unstructured":"Randell, B. (2007), \u201cA computer scientist's reactions to NPfIT\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 222\u201034.","DOI":"10.1057\/palgrave.jit.2000106"},{"key":"key2022012720401483200_b40","doi-asserted-by":"crossref","unstructured":"Sauer, C. and Willcocks, L. (2007), \u201cUnreasonable expectations \u2013 NHS IT, Greek choruses and the games institutions play around mega\u2010programmes\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 195\u2010201.","DOI":"10.1057\/palgrave.jit.2000108"},{"key":"key2022012720401483200_b41","unstructured":"Smith, A.E. (2005), \u201cLeximancer manual\u201d, unpublished manuscript, The University of Queensland, Brisbane."},{"key":"key2022012720401483200_b42","doi-asserted-by":"crossref","unstructured":"Smithson, S. and Hirschheim, R.A. (1998), \u201cAnalysing information systems evaluation: another look at an old problem\u201d, European Journal of Information Systems, Vol. 7 No. 3, pp. 155\u201074.","DOI":"10.1057\/palgrave.ejis.3000304"},{"key":"key2022012720401483200_b43","unstructured":"Snowden, D.J. and Boone, M.E. (2007), \u201cA leaders framework for decision making \u2013 wise executives tailor their approach to fit the complexity of the circumstances they face\u201d, Harvard Business Review, Vol. 85 No. 11, pp. 68+."},{"key":"key2022012720401483200_b44","doi-asserted-by":"crossref","unstructured":"Spoor, S.T.P., Stice, E., Burton, E. and Bohon, C. (2007), \u201cPathways to help\u2010seeking in bulimia nervosa and binge eating problems: a concept mapping approach\u201d, International Journal of Eating Disorders, Vol. 40 No. 6, pp. 493\u2010504.","DOI":"10.1002\/eat.20402"},{"key":"key2022012720401483200_b45","doi-asserted-by":"crossref","unstructured":"Stockdale, R. and Standing, C. (2006), \u201cAn interpretive approach to evaluating information systems: a content, context, process framework\u201d, European Journal of Operational Research, Vol. 173 No. 3, pp. 1090\u2010102.","DOI":"10.1016\/j.ejor.2005.07.006"},{"key":"key2022012720401483200_b46","doi-asserted-by":"crossref","unstructured":"Travaglia, J.F., Westbrook, M.T. and Braithwaite, J. (2009), \u201cImplementation of a patient safety incident management system as viewed by doctors, nurses and allied health professionals\u201d, Health, Vol. 13 No. 3, pp. 277\u201096.","DOI":"10.1177\/1363459308101804"},{"key":"key2022012720401483200_b47","unstructured":"Ulieru, M. and Ionescu, D. (2006), \u201cPrivacy and security shield for health information systems (e\u2010health)\u201d, Computer Systems Science and Engineering, Vol. 21 No. 3, pp. 215\u201021."},{"key":"key2022012720401483200_b48","doi-asserted-by":"crossref","unstructured":"Watson, M., Smith, A. and Watter, S. (2005), \u201cLeximancer concept mapping of patient case studies. Knowledge\u2010based intelligent information and engineering systems, pt 3\u201d, in Khosla, R., Howlett, R.J. and Jain, L.C. (Eds), Proceedings 3683, Presented at the Ninth International Conference on Knowledge\u2010Based Intelligent Information and Engineering Systems in Melbourne, 14\u201016 September, pp. 1232\u20108.","DOI":"10.1007\/11553939_171"},{"key":"key2022012720401483200_b49","doi-asserted-by":"crossref","unstructured":"Win, K.T. and Fulcher, J.A. (2007), \u201cConsent mechanisms for electronic health record systems: a simple yet unresolved issue\u201d, Journal of Medical Systems, Vol. 31 No. 2, pp. 91\u20106.","DOI":"10.1007\/s10916-006-9030-3"},{"key":"key2022012720401483200_b50","doi-asserted-by":"crossref","unstructured":"Wyatt, J.C. and Wyatt, S.M. (2003), \u201cWhen and how to evaluate health information systems?\u201d, International Journal of Medical Informatics, Vol. 69 No. 3, p. 251.","DOI":"10.1016\/S1386-5056(02)00108-9"},{"key":"key2022012720401483200_b51","doi-asserted-by":"crossref","unstructured":"Beale, T. (2005), \u201cThe Health Record \u2013 why is it so hard?\u201d, in Haux, R. and Kulikowski, C. (Eds), IMIA Yearbook of Medical Informatics: Ubiquitous Healthcare Systems, Schattauer, Stuttgart, pp. 301\u20104.","DOI":"10.1055\/s-0038-1638233"},{"key":"key2022012720401483200_b52","doi-asserted-by":"crossref","unstructured":"Becker, M.Y. (2007), \u201cInformation governance in NHS's NPfIT: a case for policy specification\u201d, International Journal of Medical Informatics, Vol. 76 Nos 5\/6, pp. 432\u20107.","DOI":"10.1016\/j.ijmedinf.2006.09.008"},{"key":"key2022012720401483200_b53","doi-asserted-by":"crossref","unstructured":"Brennan, S. (2007), \u201cThe biggest computer programme in the world ever! How's it going?\u201d, Journal of Information Technology, Vol. 22 No. 3, pp. 202\u201011.","DOI":"10.1057\/palgrave.jit.2000104"},{"key":"key2022012720401483200_b54","unstructured":"Canadian Institute for Health Information (CIHI) (2005), Available at: http:\/\/secure.cihi.ca\/cihiweb\/splash.html (accessed 17 January 2008)."},{"key":"key2022012720401483200_b55","unstructured":"Mark, A.L. (2006), \u201cResearching practice or practicing research: innovating methods in health\u2010care \u2013 the contribution of Cynefin,\u201d in Casebeer, A.L. and Mark, A. (Eds), Innovations in HealthCare, Palgrave Macmillan, Middlesex University Digital Repository, London."},{"key":"key2022012720401483200_b56","unstructured":"QINETIQ NHS (2005), \u201cConnecting for health process capability appraisal prepared for the national audit office by QINETIQ\u201d, available at: www.nao.org.uk (accessed 28 April)."},{"key":"key2022012720401483200_b57","doi-asserted-by":"crossref","unstructured":"Smith, A.E. and Humphreys, M.S. (2006), \u201cEvaluation of unsupervised semantic mapping of natural language with Leximancer concept mapping\u201d, Behavioral Research Methods, Vol. 38 No. 2, pp. 262\u201079.","DOI":"10.3758\/BF03192778"},{"key":"key2022012720401483200_b58","doi-asserted-by":"crossref","unstructured":"Suntharalingam, G., Cousins, J., Gattas, D. and Chapman, M. (2005), \u201cScanning the horizon: emerging hospital\u2010wide technologies and their impact on critical care\u201d, Critical Care, Vol. 9 No. 1, pp. 12\u20105.","DOI":"10.1186\/cc3046"}],"container-title":["Journal of Systems and Information Technology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.emeraldinsight.com\/doi\/full-xml\/10.1108\/13287260910983605","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/13287260910983605\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/13287260910983605\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:24:15Z","timestamp":1753403055000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/jsit\/article\/11\/3\/208-229\/250952"}},"subtitle":[],"editor":[{"given":"Rosemary","family":"Stockdale","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2009,8,14]]},"references-count":58,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009,8,14]]}},"alternative-id":["10.1108\/13287260910983605"],"URL":"https:\/\/doi.org\/10.1108\/13287260910983605","relation":{},"ISSN":["1328-7265"],"issn-type":[{"type":"print","value":"1328-7265"}],"subject":[],"published":{"date-parts":[[2009,8,14]]}}}