Communications of the ACM
Documents and professional practice: “bad” organisational reasons for “good” clinical records
CSCW '96 Proceedings of the 1996 ACM conference on Computer supported cooperative work
Sorting things out: classification and its consequences
Sorting things out: classification and its consequences
Process descriptions as organisational accounting devices: the dual use of workflow technologies
GROUP '01 Proceedings of the 2001 International ACM SIGGROUP Conference on Supporting Group Work
Evaluating Health Care Information Systems: Methods and Applications
Evaluating Health Care Information Systems: Methods and Applications
Making a Case in Medical Work: Implications forthe Electronic Medical Record
Computer Supported Cooperative Work
Incorporating ideas from computer-supported cooperative work
Journal of Biomedical Informatics
ICT and Integrated Care: Some Dilemmas of Standardising Inter-Organisational Communication
Computer Supported Cooperative Work
Mobility Work: The Spatial Dimension of Collaboration at a Hospital
Computer Supported Cooperative Work
Representations at work: a national standard for electronic health records
CSCW '06 Proceedings of the 2006 20th anniversary conference on Computer supported cooperative work
The Field Guide to Understanding Human Error
The Field Guide to Understanding Human Error
An observational study on information flow during nurses' shift change
Proceedings of the SIGCHI Conference on Human Factors in Computing Systems
Coordinating heterogeneous work: information and representation in medical care
ECSCW'01 Proceedings of the seventh conference on European Conference on Computer Supported Cooperative Work
Documents in Place: Demarcating Places for Collaboration in Healthcare Settings
Computer Supported Cooperative Work
Proceedings of the 2008 ACM conference on Computer supported cooperative work
Documenting transitional information in EMR
Proceedings of the SIGCHI Conference on Human Factors in Computing Systems
CPOE workarounds, boundary objects, and assemblages
Proceedings of the SIGCHI Conference on Human Factors in Computing Systems
Accounting and Co-Constructing: The Development of a Standard for Electronic Health Records
Computer Supported Cooperative Work
A Review of 25 Years of CSCW Research in Healthcare: Contributions, Challenges and Future Agendas
Computer Supported Cooperative Work
| Hi-index | 0.00 |
Electronic Medical Records promise to simultaneously enhance coordination and provide transparency and accountability in work process. As such, EMR are purported to benefit both hospitals and patients. In this paper we use grounded empirical data to explore how this promise plays out in the everyday tasks of healthcare providers. Building on the small body of CSCW literature that suggests that the accounting functions of EMR are impinging on the ability of medical personnel to coordinate work, we draw on the theoretical lens of new institutionalism to outline how certain institutional logics around safety and accountability are shaping the experience of EMR systems in situ. We suggest that the institutional logics that currently characterize U.S. healthcare are embedded in the EMR design itself, structuring how institutional values such as 'safety' are achieved and evaluated. Using over one year of ethnographic research in an obstetrical unit, we find that the institutional logics of 'safety' embedded in the EMR create negative organizational outcomes, effectively undermining coordination and necessitating inaccurate accounts of work. We provide design implications to address these issues in the current institutional environment and envision how systems might be designed to promote alternate logics of safety that are social, dynamic, and cast humans as expert agents in the system.