Minding the Boundary: Electronic Health Records and the Transformation of U.S. Healthcare Practice

摘要

The U.S. healthcare system is riding a wave of clinical health IT investment, centered on electronic health records (EHR) systems adoption. Supported by governmental incentives, this build-out has positioned the healthcare system for a period of transformation as EHR functionality becomes ingrained in the work routines of healthcare providers and other system participants. We report on a field study of healthcare participants to explore the influence of EHR adoption on the boundaries and practices of the field. Our grounded theory analysis reveals the interplay between the field practices of individual communities and the boundary spanning practices that unite them. Through the adoption of a practice perspective, we assess the varied boundary object aspects of EHR systems and their influence on boundary spanning and field practices alike. We conclude with a consideration of the positive and potentially negative consequences of widespread EHR use for delivery of healthcare services.