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This paper sums up some of the findings from a national survey on the diffusion and use of Electronic Health Record (EHR) systems in the Norwegian health sector. The survey shows that almost all hospitals and GPs use their EHR systems on a daily basis, while the municipalities are lagging behind, All three view costs and missing functionality as the most important challenges. The GPs are very concerned with the complexity of the daily operation of the systems, while the hospitals are mostly concerned with costs of daily operations, maintenance and further development of the systems. Better integration with support systems is requested. User involvement and ownership seem to have contributed to the development and diffusion of the most successful EHR systems. National diffusion processes require good planning and are time consuming. It has taken 15 years from the first EHR systems were introduced until 90% of the actors used the systems. This has to be taken into account in national strategy processes in the health sector.
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