HERO (Healthcare Electronic Records in Organisations)

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A major innovation in the NHS is a fully electronic patient record (EPR) that allows data to be transferred (e.g. between general practice and pharmacies or hospitals), and which also provide automatic prompts to make sure the doctor or nurse remembers to do the right tests and provide the right treatment (evidence based practice). But medical work is complex, and the EPR does not fit seamlessly into the way doctors, nurses and managers tend to go about their business. This study, which draws heavily on recent theoretical and methodological insights from organisational scientists in the USA, takes a new look at what the EPR is really for. Instead of considering it as a container for knowledge about the patient, we view the EPR as an ORGANISER for collaborative work practices around the patient s unfolding illness trajectory. In other words, the EPR tells the numerous health professionals, administrators and managers what they have to do when and in what order (and where the patient has to be), to ensure that an appropriate package of care is delivered. We will use a multi-method, multi-site case study approach (based on the work of Yin) to study these work practices and how the EPR enhances, develops, and threatens them. The goal of the research is to produce a pragmatic model for supporting NHS organisations in implementing the EPR and comparable complex technologies.