Please stop buying yesterday’s 'all inclusive' Health IT-systems! - Online lunch seminar

Welcome to my online (HI Conversation) lunch seminar tomorrow Thursday June 13, 12.00-13.00 Central European Summer Time (CEST), titled “Please stop buying yesterday’s ‘all inclusive’ Health IT-systems!”. Free registration is needed to get the Zoom link from Karolinska Institutet

Swedish regions have bought “new” monolithic Electronic Health Record (EHR) systems to replace their even older monolithic EHR systems. Experiences indicate that such transition processes are painful. This short talk highlights some of the well-known root causes of integration problems and the common strategies available to handle them. Buying a monolithic EHR is just one of the strategies, and nowadays usually not the best strategy at the complexity level of a big Swedish healthcare region. The Spanish region Catalonia and many others (including in Scandinavia) are instead going for a more open platform approach using vendor-neutral standards like openEHR and FHIR and avoid monolithic EHR systems. Karolinska University Hospital has started using such a platform approach internally and hope to extend the usage to others.

The transition to a monolith EHR usually uses up resources and stalls most other development during years. An “all-inclusive effect” often starts already when buying a monolith is considered, and then continues during the lifetime of the contract. The “all-inclusive effect” is a combination of economic lock-in, transition fatigue and integration difficulties. It is often expressed in terms like “Yes the monolith does not support your clinical IT-need X very well yet, but the system supplier has promised to improve, please don’t suggest/consider any objectively better competing solution. We are already bound in a 12-year contract paying for the monolith’s (possibly inferior) functionality covering need X. Also it was a pain to do the transition and integrations so we won’t have energy and resources even if the competing solution would be free or cheap.”

Time for questions and discussion is planned toward the end of the seminar.

Info page at Karolinska Institutet: HI Conversations - Please stop buying yesterday’s 'all inclusive' Health IT-systems! | Karolinska Institutet

Free registration to get zoom link:

Linkedin post: Erik Sundvall on LinkedIn: HI Conversations - Please stop buying yesterday’s 'all inclusive' Health…


I would be happy if there is more talk about the benefits using openEHR than blackmailing monolith systems in a negative way - and they are not closed and mostly there are separate vendors for lab, pacs, hr, logistic,… my employee has about 2000 systems and 100+ vendors. Only on of them is Epic.

ke 12. kesäk. 2024 klo 10.11 Erik Sundvall via openEHR <> kirjoitti:

Hi Erik,

Will the session be recorded? Will it be available afterwards?


@Daniel.Alomar I’ll ask the hosts if it can be recorded and published, if so I will post a link here when the recording is available.

@JuhaMuinonen I’m usually tryinig to explain that suppliers of “monolith” systems and other traditional systems are not necessarily evil, but rather usually have very good intentions and plans (but that often take longer to implement than both the suppliers and their customers want). The supppliers actually try to respond as best they can to procurements. It is usually the buyers’ procurement processes and requirements that are based on the wrong (often old) assumptions.

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The seminar part before the Q&A-session was recorded and will be made available later. The slides are available now via 2024-06-13-Please-stop-buying-yesterdays-all-inclusive-health-IT-systems.pptx - Google Präsentationen


Fantastic Erik!

Really enjoyed it, thank you!

Hello – is the recording also available online?