Making a case in medical work: Implications for the electronic medical record

The introduction of the electronic medical record (EMR) is widely seen by healthcare policy makers and service managers alike as a key step in the achievement of more efficient and integrated healthcare services. However, our study of inter-service work practices reveals important discrepancies between the presumptions of the role of the EMR in achieving service integration and the ways in which medical workers actually use and communicate patient information. These lead us to doubt that technologies like the EMR can deliver their promised benefits unless there is a better understanding of the work they are intended to support and the processes used in its development and deployment become significantly more user-led.