Paper short abstract:

In this study we use a biographical approach to examine the market of HEPMA systems in England. This approach allows us to evaluate our findings in light of the history of Enterprise Solutions, and draw on the lessons for the commercial supply of increasingly complex solutions for the health sector.

Paper long abstract:

This paper uses a biographical approach to explore the evolution of 'packaged' HEPMA systems in NHS England. We used a longitudinal multi-case study, which examined the views of diverse arrays of players. This perspective showed that the standard HEPMA systems, built around generic models of the user organisation, may be far removed from the structure and processes of particular adopting organisations, necessitating a considerable effort for customization to meet the needs of adopting organizations.

In NHS England, centralised procurement of health systems encountered numerous problems, resulting in a shift to 'locally chosen and implemented systems' Public policies promoting adoption of HEPMA have led to swarming entrance of immature systems into the UK market. Low levels of experience and knowledge both on supply and use sides have led to problematic implementations.

The biographical approach allowed us to see similarities between the history of HEPMA and Enterprise Solutions, in which the UK government's attempts to promote Computer Aided Production Management prompted a similar entrance of immature 'unfinished' products into the market leading to failed implementations. Only later Enterprise Resource Planning systems did enter the market with generic features that could bridge to the range of operating procedures found in particular sectors.

Our findings suggests that public policies for technology promotion need to be considered in relation to the maturity of the technology market, and also health technology markets and 'technological fields' emerge and mature over time through complex contributions of 'communities' of vendors and users (Pollock and Williams, 2009).