The Travel to the Hidden Lives of the Electronic Medical Record (EMR)

Over the last years, we have been witnessing the spread of Information Communication Technologies (ICTs) in the healthcare sector, where ICTs have often been seen as magic formulas that can be applied to achieve better healthcare. Consequently, various initiatives are being taken in the name of efficiency and cost reduction, and the implementation of Electronic Medical Records (EMRs) is prominent among these. There is an increasing focus on standardization, evidence-based medicine, and patient self-care. While, EMRs have reached the stage where various benefits are expected to accrue, however, a sociotechnical approach to the hidden lives of electronic records, reveal multiple contingencies and ambiguities. The transformation to a so-called digital realm brings along various benefits, but it also poses new challenges. For instance, increased access and data sharing across professional borders raises various ethical and legal issues concerning privacy and confidentiality of information. In this study, I will follow the hidden lives of the EMRs in six Community Health Centres in British Columbia, Canada (focusing primarily on one clinic). This will allow me to explore the invisible layers behind such a transition, and shed a light at the challenges and complexities that are faced before and after the actual implementation. I will look at how electronic records impact existing work practices, and how do they participate in redefining roles and responsibilities between the various healthcare professionals. The aim is to elucidate the ambiguities of these technologies and thereby capture the tension between the visible and the hidden lives, as well as the envisioned and the existing reality.