Digital Transformation under a pandemic: A case study of Covid-19 contact tracing in Norway

Abstract

In March 2020 the number of confirmed COVID-19 cases in Norway increased rapidly, and the efforts to trace contacts of positive cases were under severe pressure. Contact tracing in Norway is the responsibility of the municipalities, and no standardized or coordinated contact tracing practices were at the time in place on the national level. The afflicted municipalities did their best to cope with the chaotic situation and did contact tracing using excel spreadsheets or pen and paper. These approaches have their flaws, and in particular, failed to scale in several municipalities. In this paper, we report from a case study of collaborative efforts made to address this challenging situation by the University of Oslo (UiO), the Norwegian Association of Local and Regional Authorities (KS), the Norwegian Public Health Institute (NPHI), and several municipalities. The DHIS2 software platform and experiences implementing DHIS2 for contact tracing in other countries were the basis for these efforts. We describe the process of designing and implementing DHIS2 to date and the experiences so far. We pay particular attention to the potential long-term implications of this process, which we see as a digital transformation of contact tracing in particular and disease surveillance in general in Norway. Our contribution is a rich case description as well as the identification of themes relevant to the further development of DHIS2 for contact tracing as well as other systems in a similar context. These themes include cross-municipal collaboration and information sharing across judicial/legal boundaries, standardisation and centralization of support structures, and potentially transformation of contact tracing practices.