Interoperability and Governance; Important Preconditions for Establishing Large-Scale Healthcare Infrastructures Like the Akson program in Norway.

In Norway there is an overall goal to establish a national digitalization platform for primary healthcare named Akson to improve information exchange. We participated in the work with Akson and through qualitative research including interviews, we found that the project could benefit from other similar infrastructuring processes. First, a national process of defining clinical standards and establishing a governance organization to handle them. Second, improving data exchange between an EHR system and a national quality registry. The aim of the paper is to outline some lessons learned from these previous processes, for Akson and similar large-scale projects focusing on how to govern the digitalization platform at different healthcare levels and how to reuse healthcare information within and across healthcare institutions. Hence, we ask the following research question: Which experiences from previous large-scale infrastructuring processes should be considered when establishing a national digitalization platform for sharing data?