Complexity and Risk in Health Information Infrastructures: An Options Analysis

Managing the development and implementation of large health information infrastructures has proved to be quite difficult in many countries. The root of the problem is managing complexity in unstable environments. In this study we investigate a large case in Norway, an ePrescription project, using a real option analysis. We offer three conclusions. First, the real option analysis is a valuable tool for analyzing not only risk in IT projects, but also for understanding the complexity issues of large health infrastructures. Second, we find that in large public health IT projects, the pressures for increased complexity are quite strong, particularly when it comes to including more stakeholders in the solutions. These pressures are well-intended, but results in choosing the options that increase the risks of the projects. Third, in such projects the forces fighting for the options of lower complexity are hard to see, and have difficulties in voicing their opinion.