The fungibility of time in claims of efficiency: The case of making transmission of prescriptions electronic in English general practice

The wider claim that healthcare information technology saves time and increases efficiency is often based on assumptions of the fungibility of time and people - i.e. that units of time added or saved on different steps of the workflow can be summed up as if they were all of the same kind, and thus reveal any net efficiency gain. But workflow time savings involve changes in the quality of tasks, redistribution of work and responsibility that mean that time can hardly be added or subtracted to obtain 'efficiency totals'.