Avdagovska, M.

Tracing the decisions that shaped the development an electronic patient portal in Alberta Canada - A historical research study
Avdagovska, M., Stafinski, T., Olson, K., & Paul, P.

Understanding the intricacies of how health organizations decide on IT investments is imperative to ensure successful implementation and eventual adoption by users. In 2016, AHS introduced a patient portal called MyChart through a proof of concept (PoC). MyChart allows patients to view appointments, medical test results, and to communicate with their providers.

The focus of this historical study was to examine the environmental and contextual factors that affected the MyChart PoC. The study was based on the 7-step framework developed by Mason et al, where one engages in a rigorous archival critical analysis (including internal and external criticism) of numerous documents and analysis of interviews. We reviewed over 423 primary and secondary sources and interviewed ten key decision makers.

Although many aspects of what occurred during the PoC are considered common, there are several features with broad implications for delivering patient portals in a large public healthcare system. Supportive leadership, project management, focused scope, appropriate technology and vendor selection, and quick decision-making were some of the facilitators that allowed for the growth of the PoC. The planning and implementation stages did not depend much on the technology itself, but on the various actors who influenced the implementation by exerting power. The main barriers were lack of awareness about technology, lack of proper training, lack of buy-in from diverse system leaders, and lack of central decision-making.

The findings highlight the importance of understanding the organizational and decision-making tactics that have the capacity to influence IT implementation. Furthermore, our findings might be unique as we found that lack of centralized planning and rapid implementation led to duplication of technologies. Future research should focus on looking at how needs assessments for IT are conducted and how they impact funding decisions.