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National Electronic Health Record Systems as ‘Wicked Projects’: The Australian Experience

Lookup NU author(s): Dr Karin Garrety, Professor Ian McLoughlin, Professor Rob WilsonORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Governments around the world are investing in large scale information and communication technology projects that are intended to modernize and streamline healthcare through the provision of nationally accessible electronic health records. In this way, they hope to `tame' the complex `wicked' problems facing healthcare, such as rising costs and fragmented delivery. However, these projects often encounter difficulties. Using a case study of Australia's 20-year journey towards a national electronic health record system, we show how these projects can ironically take on the characteristics of the `wicked problems' they are intended to solve, and how a failure to recognize and cope with these `wicked' characteristics can lead to waste, conflict and frustration among potential users. We suggest some alternative approaches to the management of large-scale ICT projects in healthcare and other public service sectors that deal with complex, sensitive data.

Publication metadata

Author(s): Garrety K, McLoughlin I, Dalley A, Wilson R, Yu P

Publication type: Article

Publication status: Published

Journal: Information Polity

Year: 2016

Volume: 21

Issue: 4

Pages: 367-381

Print publication date: 22/12/2016

Online publication date: 20/07/2016

Acceptance date: 02/04/2016

Date deposited: 28/07/2016

ISSN (print): 1570-1255

ISSN (electronic): 1875-8754

Publisher: IOS Press


DOI: 10.3233/IP-160389


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