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Health Information Systems Implementation: A Beforeand- After Observational Study

While technical challenges persist in health information systems, many of these implementations fail because of organizational issues. A major criticism of health information systems, which include electronic health records (EHR) and computerized physician order entry (CPOE), is that their underlying model is too simplistic and does not reflect the complexity and fluidity of healthcare practice. This has led to systems that cannot adequately support the dynamic and contingent nature of clinical work or facilitate communication and collaboration among clinicians. Studies of unexpected consequences of EHR implementations reveal social and political impacts, and that many contextual factors are not well understood or their importance underemphasized. Using a before-and-after observational study design and adopting the sociotechnical systems perspective, this study analyzes impacts of an EHR on clinician workflow, time allocation and communication, and provides useful insight into how such systems affect user work activities, thereby informing future health information system adoptions and implementations.