Experiences with an electronic patient record in a clinical context: considerations for design

This paper argues that we should see medical work practices as natural systems, and that we should understand the process of IT design as the development of sociotechnical configurations. Drawing upon our experiences with an electronic patient record (EPR) on an Intensive Care Unit, several considerations for design are developed. First, the EPR should not be overly structured with rationalistic and pre-fixed notions of the organization and content of medical work. Second, it is crucial to ensure that the usage of the system will yield immediate benefits for primary users: the systems should support work; not generate it. Third, designing IT should include being aware of the socio-political nature of seemingly 'neutral' tools as EPRs.