Discursive formations and Shifting Strategies in E-Health programmes

Research has shown that large IT programmes in e-government and e-health are challenging not only in terms of project failures and in terms of high costs, but also that the public and sectorial discourses greatly influences the trajectories and outcomes of mega-programmes. However, few IS studies have investigated this phenomenon in much depth, and the aim of this contribution is to shed more light on the relationship of discourse and mega-programmes. We use Foucault’s discourse concept to analyse discursive formations aiming to promote and establish solutions in e-health programs, but frame our investigation in information infrastructure theory. Our empirical evidence is a 15-year study of the growth of the national e-health infrastructure in Nor-way, where we analyse the interplay of the national eHealth discourse and the various programme ini-tiatives. Our study offers two contributions. First, we demonstrate how the concept of discursive for-mation allows for an in-depth analysis of the role of discourse in large eHealth programs. Second, we show how shifts of discourse, combined with experienced problems in on-going programs, may disrupt the trajectories of large information infrastructures.