Good friends in Oslo (Margunn Aanestad, Miria Grisot, Ole Hanseth and Polyxeni Vassilakopoulou) have just launched their edited a book on Information Infrastructure within European Health Care. The book is open-access meaning you can download it for free here.
Our team’s contribution is chapter 8 which discusses England’s Electronic Prescription Service that we evaluated for NPfIT over a number of years. This service moved UK GPs away from paper prescriptions (FP10s – the green form) to electronic messages sent directly to the pharmacy. We examine the making of the EPS temporally by looking at: (1) How existing technology (the installed base) and historical actions affect the project. (2) How the present practices and the wider NPfIT programme influenced. (3) How the desired future, reflected in policy goals and visions, influenced the present actions.
England’s Electronic Prescription Service
Ralph Hibberd, Tony Cornford, Valentina Lichtner, Will Venters, Nick Barber.
We describe the development of the Electronic Prescription Service (EPS), the solution for the electronic transmission of prescriptions adopted by the English NHS for primary care. The chapter is based on both an analysis of data collected as part of a nationally commissioned evaluation of EPS, and on reports of contemporary developments in the service. Drawing on the notion of an installed infrastructural base, we illustrate how EPS has been assembled within a rich institutional and organizational context including causal pasts, contemporary practices and policy visions. This process of assembly is traced using three perspectives; as the realization and negotiation of constraints found in the wider NHS context, as a response to inertia arising from limited resources and weak incentive structures, and as a purposive fidelity to the existing institutional cultures of the NHS. The chapter concludes by reflecting on the significance of this analysis for notions of an installed base.