Bright visions, shady days: Exploring hospital staff expectations and early experiences with a new EHR system in Norway

<b>Background:</b> The preparation phase of an IT implementation may have consequences for the outcomes. To increase the chance of a successful implementation, many organisations invest in preparing the organisation through organisational readiness projects and similar activities. <b>Objective:</b> To determine how hospital staff in Central Norway were prepared for a new electronic health record (EHR) system and how expectations were met during the go-live and early use phase. <b>Methods:</b> Semi-structured interviews with the implementation team and staff members of a University hospital. <b>Results:</b> Preparations were carefully planned, but the staff considered them insufficient. The staff were positive towards the aim of the new EHR but found the training and practical preparations inadequate, resulting in unmet expectations and frustrations. <b>Conclusion:</b> Readiness activities in socio-technical implementations should emphasise to users that the information system presents opportunities, not necessarily fixed-use recipes, and is continuously evolving. Contextual information can help users align their expectations with the possibilities.