A media analysis approach to evaluating national health information infrastructure development

The purpose of this paper is to evaluate electronic health record (EHR) initiatives at the national/external level. Governments are investing large amounts of money in national EHR systems. These systems are socially and politically complex and a variety of stakeholders (e.g. at the individual, organisational or national level) have an interest in evaluating such systems from technical, economic or patient outcome perspectives. In cognisance of academic research in the area, this paper presents an approach which uses the perspective of one particular type of professional critic, the media, to identify issues and evaluate their impact at a national level.

The work is conducted using an established evaluation framework and formal content analysis of selected relevant articles from the quality press of three selected countries.

Different issues take prominence in centralised vs decentralised EHR approaches. In countries with a decentralised approach issues of standards and interoperability take the fore. Where there is a more centralised approach the media focus is more on project management, budgetary and financial aspects. In all coverage political and economic aspects are emphasised over technical or patient outcome issues.

The paper represents the application of the content‐context‐process framework. It contributes to the information systems evaluation literature at the national/external level.