Affiliations: [a] School of Management, Operations and Marketing, University of Wollongong, Northfields Ave, Wollongong, NSW, Australia | [b] Monash Business School, Monash University, Caulfield Campus, Melbourne, Victoria, Australia | [c] Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Ave, Wollongong, NSW, Australia | [d] Newcastle University Business School, Newcastle University, Newcastle Upon Tyne, Australia | [e] School of Information Systems and Technology, University of Wollongong, Northfields Ave, Wollongong, NSW, Australia
Correspondence:
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Corresponding author: Karin Garrety, School of Management, Operations and Marketing, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia. Tel.: +61 2 4229 2161; E-mail:[email protected]
Abstract: 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.
Keywords: Information technology, electronic health records, wicked problems, Australia
