The impact of electronic health records on collaborative work routines: A narrative network analysis

The process of the EHR implementation and the changes observed was the confluence of three factors: resource constraint - in particular EHR expertise and experience - not uncommon in many community hospitals; the functional properties of the EHR focusing on information aggregation, storage, and retrieval; and the extant culture and practice of healthcare emphasizing autonomy and flexibility. While collaborative and communication changes were prompted by EHR implementation, the system played a minimal role in mediating changes. Instead, changes in work routines were negotiated between the administration and clinicians, and jointly refined over time.