Scrapping the millennium: introduction of a health record in Sweden fails

Together with other Scandinavian countries, Sweden is considered a model country for digitalization, particularly in the healthcare sector. The Millennium software suite from Oracle Health was to replace dozens of different and outdated IT systems in the two southern Swedish health districts of Västra Götalandsregionen and Region Skåne. The aim was to make working with patient data more efficient and easier. However, just three days after the new system was put into operation in mid-November, it had to be stopped again, and the old systems had to be reverted to. The reason for this was massive and vociferous protests from staff, who felt that patient safety was no longer guaranteed.

One doctor described the new system in the Swedish daily newspaper Göteborgsposten as a “hamster wheel of hell”. In other media reports, several employees also described the system as confusing and old-fashioned. As basic functions were not working, employees in some departments were forced to resort to pen and paper.

Poorly calculated schedule and incomplete preparations

An external audit by the auditing firm KPMG has now provided further points of criticism regarding the implementation of the new system (PDF). The comprehensive investigation shows that the organization was not adequately prepared for the introduction of Millennium and that there was a lack of leadership. Some political representatives now also want to end the project, which has so far cost the equivalent of 500 million euros, altogether.

Twenty doctors from the Skåne region share this opinion. In an open letter in December, they called for the introduction of Millennium planned for March 2025 to be stopped in their region and for the plans to be scrapped altogether. The launch has now been postponed until after the summer.

This is not the first time that the introduction of Millennium has been put on hold. The system was purchased back in 2018, and Region Västra Götaland's goal at the time was to introduce it in the spring of 2021. Among other things, it has taken time to adapt the extensive health information system to the Patient Data Act.

“Pouring liquid cement into the organization”

Millennium's basic idea is to be an information system for everything. But this centralized approach is also the problem, says Johan Magnusson, Professor of Information Systems at the University of Gothenburg. In an interview with the Swedish daily Svenska Dagbladet, he describes this approach as “pouring liquid cement into the organization”.

The system has also been criticized elsewhere. Several Finnish health districts had already halted the planned introduction of Millennium in 2021 after hundreds of doctors voiced fierce criticism. Millennium had been developed for American and not Nordic conditions, they said.

There were also problems with Millennium in the USA. The United States Department of Veterans Affairs (VA) operates very large healthcare facilities and has been using the software for several years. In a major investigation in September 2024, 826 cases of “serious performance issues” with the Oracle software were identified over a period of 3.5 years. In interviews, employees described the new electronic health record system as a “system shock” that had led to increased stress and burnout among staff.

Millennium was originally developed in the 1990s by the American company Cerner. In 2022, Cerner was acquired by Oracle and renamed Oracle Health.

(mch)