Digital health platforms: a reflection on unexpected consequences and patient empowerment

An Electronic Health Record (EHR) platform, used to share medical information during patients’ care path, often leads to a range of unintended consequences, which have significant impacts on its implementation. The extant studies on technology-driven organizational change concentrated on intended results that the implementer had in mind. This focus neglects unintended consequences of goal oriented changes in healthcare. To shed light on this important topic, we examined the important intended consequences of implementing an EHR platform and their impacts on different types of care actors. Our study uses a grounded theory approach. We found that an EHR platform affords care actors to deliver intended consequences such as to connect multiple care settings, to provide rich and updated information for planning and remote monitoring, to provide continuous access to medical data and to improve the quality of care. However, if salient digital affordances and social forces are not anticipated, the system is likely to create multiple unintended consequences. If their dysfunctional side effects are not mitigated, they tend to outweigh the benefits of the platform and lead to undesirable organizational change. Our study contributes to the literature by deepening our understanding of the relationship between digital affordances, their unexpected consequences, and their impacts on digital platform implementation.