The DOI matches its Crossref record; 213 of the 223 references it cites were found in a registry or an index; none of the 72 sources its claims cite is checked for support yet.
Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta‐narrative Method
Open accessAbstract
Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Methods: Using the meta‐narrative method and searching beyond the Medline‐indexed literature, this review used “conflicting” findings to address higher‐order questions about how researchers had differently conceptualized and studied the EPR and its implementation. Findings: Twenty‐four previous systematic reviews and ninety‐four further primary studies were considered. Key tensions in the literature centered on (1) the EPR (“container” or “itinerary”); (2) the EPR user (“information‐processer” or “member of socio‐technical network”); (3) organizational context (“the setting within which the EPR is implemented” or “the EPR‐in‐use”); (4) clinical work (“decision making” or “situated practice”); (5) the process of change (“the logic of determinism” or “the logic of opposition”); (6) implementation success (“objectively defined” or “socially negotiated”); and (7) complexity and scale (“the bigger the better” or “small is beautiful”). Conclusions: The findings suggest that EPR use will always require human input to recontextualize knowledge; that even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper may offer a unique degree of ecological flexibility; and that smaller EPR systems may sometimes be more efficient and effective than larger ones. We suggest an agenda for further research.
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66 No basis given · 60 Not checked yet · 23 Own result · 15 Own interpretation · 2 Own method
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“Nine Meta-narratives That Have Driven Research on the EPR in Organizations”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
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“Even when these preconditions were present, success was not guaranteed”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 2: Change Management Studies within Health Services Research
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““Successful” implementation requires accommodation among perspectives.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 4: Information Systems (Interpretivist Approaches)
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“They have shown that clinical knowledge is often tacit, context bound, and ephemeral rather than codifiable, transferable, and enduring.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
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“Much (though not all) of health informatics has assumed that the benefits of a well-designed EPR with built-in “evidence-based” decision support are intrinsic and self-evident.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
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“we were surprised that none of the reviews in this tradition included an estimate of its extent.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
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“These rich ethnographies have illustrated, often in meticulous detail, that collaborative clinical work involves the ordering and coordination of tasks, which requires the real-time processing of local information.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
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“Our findings indicate that these hopes have yet to be realized.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 5: Information Systems (Technology-in-Practice Approaches)
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“Externally imposed deadlines and technical requirements constrain the process of mutual adaptation by which technologies and work processes become aligned.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 4: Information Systems (Interpretivist Approaches)
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In the paper
“The studies consistently showed that introducing the EPR in an organization or across organizations is a complex task.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 2: Change Management Studies within Health Services Research
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In the paper
“We found eleven studies in this tradition, including papers that drew on institutional theory (Currie and Guah 2007), symbolic interactionism (Prasad 1993), organizational sense making (Brown and Jones 1998;Desjardins, Lapointe, and Pozzebon 2006), and “soft systems” action research (Checkland and Holwell 1998).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 4: Information Systems (Interpretivist Approaches)
What the sources say
- Not checked yetcites Currie and Guah 2007
- Not checked yetcites Prasad 1993
- Not checked yetcites Brown and Jones 1998
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“We found only three empirical studies in positivist IS research relevant to our research question (listed in table 2), all of which demonstrated that model-based analyses of the determinants of EPR success left much of the observed variance unexplained.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 3: Information Systems (Positivist Approaches)
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“We found a complex and heterogeneous literature characterized by diverse philosophical assumptions about the nature of reality (ontology), how that reality might be known (epistemology), and the preferred research approaches and study designs (methodology).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
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“The ninety-four primary studies (described in 129 papers) outside the health informatics literature were philosophically pluralist, with 14 percent positivist, 19 percent interpretivist, 22 percent critical, and 55 percent recursive.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
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In the paper
“Our exploratory reading identified a number of historical roots that informed later research on the EPR (see figure 2), including”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
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“In the latter literature, at least until recently, neither the technology nor its social context was considered in depth.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
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In the paper
“Twenty-four previous systematic reviews and ninety-four further primary studies were considered.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Abstract
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In the paper
“As table 3 shows, they also were methodologically diverse, most with different types of case studies.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
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In the paper
“In relation to the EPR, this adaptation does not appear to be taking place or, at least, not taking place smoothly or unproblematically.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 5: Information Systems (Technology-in-Practice Approaches)
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In the paper
“Key tensions in the literature centered on (1) the EPR (”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Abstract
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In the paper
“Key influences on the structuration process include the affordances (see the glossary) of the technology, the constraints of time and space, the conflicting meanings attached to the EPR by different groups, the patterns of human action and interaction associated with them, and how different “genres” of medical records are used and combined in both traditional and contemporary patterns of care.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 5: Information Systems (Technology-in-Practice Approaches)
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“We found sixteen empirical studies in this meta-narrative (for details, see table 2), most of which were single-site or multisite organizational case studies, each of which had considered the impact of a range of potential enabling or constraining factors on the fortunes of a project to implement a new EPR system.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 2: Change Management Studies within Health Services Research
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In the paper
“We found eleven empirical studies on the EPR using this tradition, and in addition, meta-narratives 7, 8, and 9 draw on the principles of CSCW.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
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In the paper
“But the findings were highly consistent across studies: there are multiple and conflicting framings of the EPR by users (assumptions about it, expectations of it, versions of the problem to which it is seen as a solution), some of which are explained by deeply held institutional values”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 4: Information Systems (Interpretivist Approaches)
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In the paper
“Our own searches found twenty-four systematic reviews in this tradition covering more than 2,000 primary studies, each of which measured the impact of the EPR on some aspect of the quality, safety, or efficiency of care.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
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In the paper
“These four positions, which are described in more detail in table 1, overlap to some extent.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
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In the paper
“Although health informatics has a large literature on technical design, it is separate from the literature on the implementation and use of such systems in organizations.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
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In the paper
“It requires a well-articulated vision and strategy, strong leadership, adequate resources, good project management, an enabling organizational culture, effective communication, and attention to human resource issues.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 2: Change Management Studies within Health Services Research
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In the paper
“Adapting and extending previous taxonomies (de Vaujany 2005; Orlikowski and Baroudi 1991), we identified four main philosophical positions:”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
What the sources say
- Not checked yetcites de Vaujany 2005
- Not checked yetcites Orlikowski and Baroudi 1991
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In the paper
“The recursive (and, to some extent, the interpretivist) research traditions share a more inclusive, holistic, and fluid view of context.Context is seen as an emergent property of action constituted by, and therefore inextricable from, an activity involving people and technologies.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Organizational Context
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In the paper
“We found twenty-two primary research studies in this tradition, along with an interdisciplinary literature review that was thorough but not explicitly systematic (Ash, Berg, and Coiera 2004).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 9: Systems Approaches to Risk and Integration
What the sources say
- Not checked yetcites Ash, Berg, and Coiera 2004
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In the paper
“As table 2 shows, we found twelve such studies of the EPR, all of which drew on CSCW as well as ANT, plus two empirically informed theoretical papers from ANT (Iedema 2003;Moser and Law 2006).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 8: Actor-Network Analyses
What the sources say
- Not checked yetcites Iedema 2003
- Not checked yetcites Moser and Law 2006
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In the paper
“Most, but not all, the tensions are between studies that take a positivist worldview (broadly, meta-narratives 1 and 3) and those that take an interpretivist, critical, or recursive worldview (broadly, metanarratives 2 and 4 through 9), although some traditions (notably CSCW) embrace more than one philosophical position.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Synthesis
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The relational view sees the EPR user as inextricably linked to (indeed, as embodying and reproducing) wider social structures, institutions, or sociotechnical relationships (and perhaps as “shaping” the EPR rather than “using” it) and thus regards the collective as more than the sum of its parts.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR User
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In the paper
“Actor-network analyses of EPR technologies are highly regarded and extensively cited in the field of science and technology studies but have been either ignored or dismissed by most previous systematic reviews of the EPR.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 8: Actor-Network Analyses
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In the paper
“When used as a formal tool (e.g., with structured templates and a requirement for data to be coded), the EPR often slows down and frustrates the clinical encounter, but it greatly accelerates the secondary uses of clinical data.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
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In the paper
“We found nine studies from a feminist perspective and three from a Foucauldian perspective.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 7: Critical Sociology
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“Critical research traditions also tend to view context as an external reality, in this case made up of economic and social structures that constrain action (and do so in an unequal and potentially oppressive way).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Organizational Context
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In the paper
“Positivist traditions tend to view clinical work as largely reducible to a series of decisions, and it follows that decision support technologies will help clinical work so long as they are properly designed and implemented.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
plainconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Positivist traditions tend to take an essentialist, functionalist, and determinist view of the EPR (it has inherent properties that will perform certain tasks and, if implemented properly, will more or less predictably improve the process and outcome of the clinical encounter).In contrast, nonpositivist traditions view the EPR as either a social construction (something whose meaning and purpose”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Indeed, this inseparability of the EPR from its context (the fact that context is constituted by the EPR-in-use) is a defining characteristic of literature that adopts a recursive philosophy.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Organizational Context
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The biomedical literature sometimes talks of “information superhighways” that will make clinical information instantly available in a way that transcends the context in which this information was originally collected (Detmer 2000).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
What the sources say
- Not checked yetcites Detmer 2000
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Despite its apparently negative conclusion that the EPR is often less fit for the purpose than paper is, the CSCW literature on the EPR does not oppose technology, for three reasons.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Interpretivist and recursive traditions hold that the very notion of an “agreeable” EPR (or a single reality represented by it) is problematic.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The former perspective explains the nonuse of the EPR as a “knowledge gap,” “skills gap,” and “motivation gap” (thus as attributes of the individual actor) for which much of the solution is the provision of information, training, and incentives.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR User
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The tension here might be expressed as “clinical work as decisionmaking” versus “clinical work as situated practice,” and between “knowledge as transferable facts” versus “knowledge as informationin-context.””
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Next we consider seven key themes, each of which has inherent tensions.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Synthesis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The alternative literature suggests that gains in the quality of care with EPR systems are likely to be relatively modest, incremental, local, and based on the study of articulations and workarounds (i.e., of the creative human work bridging the gap between technical design and clinical reality), although this view still recognizes the major potential efficiency savings that EPR systems offer for”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
hedgedconditional- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The three studies from a (broadly) Foucauldian perspective link the introduction of the EPR with the rise in managerial surveillance and control of clinical work and draw on Foucault's concept of the panopticon.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 7: Critical Sociology
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Overall, this metanarrative provides considerable evidence that even though EPRs may contain features that protect against error, they also introduce new risks of their own, including cognitive overload, loss of overview, errors in data entry and retrieval, excessive trust in electronically held data, and the tendency to conflate data entry with communication within and among care teams (Ash et al”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 9: Systems Approaches to Risk and Integration
What the sources say
- Not checked yetcites Ash et al. 2009
- Not checked yetcites Weiner et al. 2007
boostedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Positivist traditions hold that the patient's condition and journey comprise a single reality to be represented in the EPR and so seek a single ideal and “agreeable” form of the record.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One aspect of the process of change that is addressed very differently by positivist and interpretivist/recursive traditions is design.As table 1 shows, there are two principal opposing philosophical positions on design: the conventional approach (whose roots are in positivism and whose focus is on engineering) and the participatory approach (whose roots are in interpretivism and whose focus is on”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The logic of opposition, in contrast, is fluid and contingent and contains inherent and unresolvable tensions.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(3) while secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work is often made less efficient;”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Policy decisions in many countries have accepted this view and used it to justify increasingly large-scale EPR initiatives (Kreps and Richardson 2007).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
What the sources say
- Not checked yetcites Kreps and Richardson 2007
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Berg talks of “growing” rather than building information systems and working to achieve synergy among three fundamental (re)design tasks: the technical system, the primary work process (e.g., clinical care), and the secondary work process (e.g., audit, management) (Berg 2003).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
What the sources say
- Not checked yetcites Berg 2003
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our review found no evidence that large-scale commercial IT systems in health care produce the benefits anticipated by their architects, and a few highquality studies suggest that they do not.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In other cases, discipline hopping produced a study that claimed allegiance to one research tradition but operated on the assumptions of another or that used a methodological approach that sounded appropriate but had not been applied rigorously or consistently.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This review identified a number of studies on how actors made sense retrospectively of EPR projects, but we found very few published studies in which a sense-making or soft-systems approach was used prospectively in action research or comparable participatory designs.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“but critics of this type of program claim that this is a flawed assumption (Berg 2000).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
What the sources say
- Not checked yetcites Berg 2000
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(5) paper will not necessarily disappear, as it offers a unique level of ecological flexibility (although workable paperless systems have been developed in one or two centers);”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The alternative view is that efficiency gains and economies of scale will never be realized because of the trade-off in loss of local, contextual detail (and thus the loss of knowledge) and the magnification of political disputes among stakeholders.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
plaindirect- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While such confused efforts at scholarship are a fact of academic life these days, the meta-narrative approach allowed us to identify systematically the distorted concepts and flawed reasoning that they contained.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In such a model, the change process is one of “good project management” that sets clear strategic goals and ensures that all parties work systematically toward these.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Accordingly, just as the “success” of a project may be talked up for political reasons, so “failed” projects should not be dismissed out of hand (Berg 2001).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
What the sources say
- Not checked yetcites Berg 2001
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This method allowed us to tease out a number of different streams of research and show how the seminal books and papers in each tradition inspired programs of theory building and empirical research.It also allowed us to compare and contrast these traditions in a structured way, as illustrated in table 2.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This review confirmed that even in the twenty-first century (when the work of researchers in other disciplines is readily accessible), most established scientists, most of the time, still operate largely within a single epistemic community and focus primarily or exclusively on the research questions being addressed by a relatively small group of colleagues.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Thus, while positivist studies of collaborative clinical work view it as largely pertaining to the exchange of information among distributed decision makers (human and technological), interpretivist and recursive models place much greater emphasis on communication, one aspect of which is contextualizing work”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The EPR tends to be introduced as part of a project or program, whose success is generally (though not always) measured by some sort of evaluation.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“These tensions are variously expressed as “competing institutional logics” (Scott 2001), the need for “accommodation” (Checkland and Holwell 1998), “sense making” (Weick 1995), “negotiating knowledge among different communities of practice” (Lave and Wenger 1991;Østerlund and Carlile 2005), or “translation” (Latour 1992), approaches that have much conceptual common ground (Fox 1999;Weber and Glynn”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
What the sources say
- Not checked yetcites Scott 2001
- Not checked yetcites Checkland and Holwell 1998
- Not checked yetcites Weick 1995
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Some papers claiming to be seminal (and sometimes cited as such) offered little more than an incoherent list of concepts and jargon phrases.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
In the paper
“Critical traditions argue that the success of an EPR project also has an ethical dimension, asking, for example, who has the power to define what counts as success, who sponsors the evaluation and what its hidden aims are, and whose interests are (and are not) represented in the evaluation (Klecun and Cornford 2005).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
What the sources say
- Not checked yetcites Klecun and Cornford 2005
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A final tension in the literature is between “the bigger the better” and “small is beautiful.””
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Progress in this meta-narrative is identified as shifting from parochial departmental HIS strategies and goals to institutional, national, and even international ones and also as the concomitant need to explore new, transinstitutional information system architectures and standards (Haux 2006).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
What the sources say
- Not checked yetcites Haux 2006
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Positivist traditions generally assume that “success” can be measured unproblematically in terms of metrics (e.g., Does the technology work?What are its uptake and usage rates?How satisfied are users?)(Mitchell and Sullivan 2001) and that transferable “success factors” can be deduced from empirical studies.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
What the sources say
- Not checked yetcites Mitchell and Sullivan 2001
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The former view is frequently expounded in the HIS literature, whereas just as electronic systems are seen as inherently better than paper, so large, integrated systems are seen as having inherently greater value than small, isolated ones (a ubiquitous truism known as Metcalfe's law).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The research conducted to date on the microdetail of collaborative clinical work from an ethnographic perspective appears to comprise fewer than twenty studies in total.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This view runs across most of the CSCW, technology-in-practice, and ANT literature and is captured in the law of medical information:”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“Hartswood, Procter, Rouncefield, Slack, and Voss (2003) offer a particularly eloquent exposition of the principles of codesign and call for the development of “shared practice” between designers and users.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
What the sources say
- Not checked yetcites Hartswood, Procter, Rouncefield, Slack, and Voss (2003)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Steve Barley's classic demonstration in 1986 that a new technology introduced into the workplace is an “occasion for structuring” offered high hopes for the study of a new generation of technologies in the health care sector (Barley 1986).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 5: Information Systems (Technology-in-Practice Approaches)
What the sources say
- Not checked yetcites Barley 1986
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Orlikowski and her colleagues demonstrated that individuals, working collectively around common tasks in organizations, actively and explicitly shape both technologies and work routines in a mutually adaptive way (Orlikowski et al. 1995).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 5: Information Systems (Technology-in-Practice Approaches)
What the sources say
- Not checked yetcites Orlikowski et al. 1995
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“But the reviewers concluded that “these [homegrown] interventions are by nature not widely generalisable” (Kupersmith et al. 2007, p. 5).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
What the sources say
- Not checked yetcites Kupersmith et al. 2007
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“As the CSCW literature also has shown, health care work is uniquely complex and dependent on the coordinated practice of multiple actors.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 5: Information Systems (Technology-in-Practice Approaches)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“CSCW developed from human-computer interaction and considers the collaborative use of computers by people in the workplace (Ackerman 2000;Grudin 1988).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
What the sources say
- Not checked yetcites Ackerman 2000
- Not checked yetcites Grudin 1988
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Car and colleagues found that while some primary studies and some, but not all, systematic reviews showed positive benefits from the EPR, the nature and magnitude of benefits were not consistent across studies, nor were there clear findings on how benefits might be maximized or what their opportunity cost might be.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
What the sources say
- Not checked yetcites Car et al. 2008
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The preceding ideas, theories, and orientations provided many of the underpinning concepts for the meta-narratives of EPR research summarized in table 2 and described in more detail later.”
- Also stated in: § Overview and Historical Roots · plain
“Different meta-narratives are drawn eclectically and in different ways on all these roots.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Overview and Historical Roots · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our sample of primary studies is thus skewed toward the nonbiomedical literature, so the following statistics should be interpreted accordingly.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Overview and Historical Roots
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Kaplan argued in 2001 that the criteria that many systematic reviewers in the HIS tradition used to select their sample of “high-quality” trials led them to focus on studies in which the very features that might explain the effect of different organizational contexts had been designed out (Kaplan 2001).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
What the sources say
- Not checked yetcites Kaplan 2001
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“These systems typically failed to meet expectations and incurred problems of fit with the detail of work practices.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
What the sources say
- Not checked yetcites Shekelle and Goldzweig 2009
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Shekelle and Goldzweig (2009) concluded that an EPR system should be considered as a complex intervention with four key components-technical, human, project management, and “organisational and cultural change”-all of which must be systematically studied.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
What the sources say
- Not checked yetcites Shekelle and Goldzweig 2009
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Information systems (IS) research is a heterogeneous tradition that emerged in business schools to consider the role of technology in business and management.It embraces a long-standing tension between positivist and nonpositivist philosophical approaches.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 3: Information Systems (Positivist Approaches)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
““Failed” EPR projects may be explained by adverse changes in the temporal or spatial structuring of work consequent on introducing new technology, the fact that knowledge is linked in complex ways to identities and social practices, and limitations of the available technology.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 5: Information Systems (Technology-in-Practice Approaches)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Of particular note is a recent 600-page “review of reviews” embracing the EPR and other information and communications technology innovations, which covered thirty-seven previous systematic reviews (Car et al. 2008).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
What the sources say
- Not checked yetcites Car et al. 2008
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“a finding that perhaps reveals the known weaknesses of contingency theories in the study of organizational change (notably that they lack precision and fail to explain much of the observed variance).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 2: Change Management Studies within Health Services Research
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This predominantly positivist tradition was developed jointly by doctors with an interest in computers and computer scientists with an interest in medicine (Gardner et al. 2009).The tradition is rooted in quantitative approaches and came to be strongly influenced by the ideas and values of EBM, with an emphasis on experimental studies; the preferred design is the RCT.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 1: Health Information Systems (HIS)
What the sources say
- Not checked yetcites Gardner et al. 2009
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The interpretivist perspective holds that the use, design, and study of information systems are fundamentally a hermeneutic (meaningmaking) process rather than a rationalistic, decision-making process (Boland 1979).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 4: Information Systems (Interpretivist Approaches)
What the sources say
- Not checked yetcites Boland 1979
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If these last two views (built, respectively, on an interpretivist and a recursive philosophy) are accepted, it follows that the impact of introducing an EPR cannot be predicted from its essential properties and hence that studies seeking to “determine the (generalizable) impact of technology X on outcome Y” have limited value.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“This alignment is achieved (or, at least, attempted) through what is known as “translation,” which involves the four stages of problematization (defining a problem for which the EPR is a solution), interessement (getting others to accept this solution to the problem), enrollment (defining the key roles and practices in the network), and mobilization (engaging others in fulfilling the roles, und”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 8: Actor-Network Analyses
What the sources say
- Not checked yetcites Callon 1986
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Technologyin-practice draws on structuration theory and sees human identity and agency as central to the analysis; it offers a sophisticated theory about what agents “know” (which, crucially, includes internalized social structures).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR User
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“since health care work is personalized, filled with exceptions, and context bound, “the nature of health care work sets natural limits to the possibilities of IT to revolutionize this work” (Berg 2003, p. 337).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
What the sources say
- Not checked yetcites Berg 2003
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The tension between standardization (which helps stabilize the network) and contingency (which reflects and responds to local needs and priorities) can never be resolved; rather, it must be actively and creatively managed-and this gets harder as the network gets bigger.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 9: Systems Approaches to Risk and Integration
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Actor-network theory (ANT) is built on a recursive philosophy (Latour 1992).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 8: Actor-Network Analyses
What the sources say
- Not checked yetcites Latour 1992
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“ANT, in contrast, considers agency to be a product of the network rather than something intrinsic to the individual actor, so such things as knowledgeability and motivation are only weakly and indirectly theorized (Mutch 2002).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR User
What the sources say
- Not checked yetcites Mutch 2002
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The EPR is not merely a container for information; it accumulates and transforms work (is “constitutive” of it) and is thus an actor (or “actant”) in the network.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 8: Actor-Network Analyses
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Second, the EPR can provide multiple views and framings of the data and thus can tolerate (and perhaps overcome) the ambiguities inherent in interprofessional work and make the work of different professional groups more visible to others (Reddy, Dourish, and Pratt 2001).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
What the sources say
- Not checked yetcites Reddy, Dourish, and Pratt 2001
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Conceptualized from the ANT perspective, EPR projects “fail” when the elements in the network fail to align, that is, when efforts at translation fail.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 8: Actor-Network Analyses
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“As one seminal paper put it, the EPR's bodies are multiple (Berg and Bowker 1997).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
What the sources say
- Not checked yetcites Berg and Bowker 1997
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While different language is used in different traditions (“ensemble,” “situated,” “embedded,” “accommodated,” “networked”), these terms share many meanings, and all place greater emphasis on system-level approaches than on interventions aimed at the individual.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR User
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Critical sociology draws on the work on power by feminist scholars and the philosopher Michel Foucault (Schneider 2006;Willcocks 2006).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 7: Critical Sociology
What the sources say
- Not checked yetcites Schneider 2006
- Not checked yetcites Willcocks 2006
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Critical sociology and ANT studies assume that power relationships are (at least to some extent) built into the structure and data models of the EPR.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because this heterogeneous literature is based on different philosophical assumptions and worldviews, a meaningful synthesis must not merely summate the findings of different meta-narratives but also present the tensions and conflicts among them as higher-order data.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Synthesis
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Rather than promising that the EPR will “save time” or “make clinical care more efficient,” a more honest message would be that creating accurate and complete clinical records requires the sacrifice of time and effort by frontline clinical and administrative staff but that this is (sometimes) justified by more benefits for efficient business processes (e.g., billing), governance, and research.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 6: Computer-Supported Cooperative Work (CSCW)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The alternative view is that clinical work is less about decision making than about addressing the ongoing, local question, what to do next?(Garfinkel 1967a)”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
What the sources say
- Not checked yetcites Garfinkel 1967a
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true.
In the paper
“In sum, technologies reflect the interests and values of those who produce them.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 7: Critical Sociology
What the sources say
- Not checked yetcites Zuboff 1988
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As described in meta-narrative 1, much of the health informatics research tradition has been oriented to designing EPR technologies that will improve patient safety by overcoming fallible human practice.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 9: Systems Approaches to Risk and Integration
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The further information has to be able to circulate (i.e. the more diverse contexts it has to be usable in), the more work is required to disentangle the information from the context of its production.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
What the sources say
- Not checked yetcites Berg and Goorman 1999
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The UK NPfIT appeared to be built on six assumptions, that the EPR (1) is primarily a container for information about the patient; (2) can be integrated seamlessly and unproblematically into clinical work; (3) will increase the effectiveness and efficiency of clinical work;”
- Also stated in: § Discussion and Recommendations · plain
“(4) will drive changes in how staff interact with the patient and one another; (5) should replace most, if not all, forms of paper record, which are old-fashioned and limited; and (6) the more comprehensive and widely distributed it is, the more value it will add.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Discussion and Recommendations · plain
In the paper
“Taken to its extreme, the logic of determinism is focused on technology and is causalist (technology X will produce output Y, and Y can be measured) and fundamentally linear (it recognizes complicatedness but not complexity) (Plsek and Greenhalgh 2001).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
What the sources say
- Not checked yetcites Plsek and Greenhalgh 2001
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It assumes that the human interactions and organizational context in which technology is used will operate on the same formal and predictable technical principles as the technology itself.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Our team developed the meta-narrative method in a previous study to synthesize heterogeneous research literature on a complex topic (Greenhalgh et al. 2004(Greenhalgh et al. , 2005)).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
What the sources say
- Not checked yetcites Greenhalgh et al. 2004
- Not checked yetcites Greenhalgh et al. 2005
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If this logic is adopted, it follows not merely that the change model will be neither linear nor predictable but also that there will be conflict involved.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Process of Change
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although this rule certainly helps explain numerous unsuccessful largescale EPR initiatives, a more nuanced version of it may now be needed to account for the uncommon examples of successful ones (see metanarrative 1).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The Impact of Change-And the Definition of Success
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“most of the benefits of current HIT systems accrue to entities upstream from direct patient care processes 72 d hospital administrators, quality improvement professionals, payors, regulators, and the government. 73”
From Health information technology: fallacies and sober realities (2010) · cites this paper as [73]
In the citing paper
“those who suffer the costs of poorly designed and inefficient HIT are front-line providers, clerks, and patients.”
From Health information technology: fallacies and sober realities (2010) · cites this paper as [73]
In the citing paper
“We also see interpretive case-based evaluation as a useful way to avoid inherent pro-innovation bias, typically embedded in before-after evaluations [1,36,77].”
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The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview
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BackgroundInfluentialHealth information technology and digital innovation for national learning health and care systems
Sheikh, A., Anderson, M., Albala, S. A., Casadei, B., Franklin, B. D., Richards, M. A., Taylor, D. G., Tibble, H., & Mossialos, E. A. (2021) · The Lancet Digital Health · doi:10.1016/s2589-7500(21)00005-4 · Cited by 465
“6 System-level change also requires being responsive to the perspective and needs of multiple stakeholders and the political, regulatory, and sociocultural context of health systems.”
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“It has therefore been proposed that ANT may be best used in a combination with other theoretical approaches, especially in relation to analysis and interpretation [47,56,57].”
BackgroundVirtual online consultations: advantages and limitations (VOCAL) study
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Self-citationRAMESES publication standards: meta‐narrative reviews
Wong, G., Greenhalgh, T., Westhorp, G., Buckingham, J., & Pawson, R. (2013) · Journal of Advanced Nursing · doi:10.1111/jan.12092 · Cited by 324
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“A key strength of this study was the use of a new theoretical and methodological approach, derived from a systematic literature review of electronic record research that deliberately went beyond the biomedical literature and embraced sociology, computer supported cooperative work, and empirical philosophy.”
BackgroundSelf-citationVelupillai, S. U., Suominen, H., Liakata, M., Roberts, A., Shah, A. D., Morley, K. I., Osborn, D., Hayes, J., Stewart, R. J., Downs, J. M., et al. (2018) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2018.10.005 · Cited by 261
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Self-citationClinical leadership and hospital performance: assessing the evidence base
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“Thus, using a meta-narrative literature review structure (Greenhalgh et al., 2004, 2005, 2009; Jerzembek and Murphy, 2012; Lauer et al., 2014), this study addresses the following research questions: RQ1.”
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“Studies have addressed unanticipated problems such as alert fatigue [14], paper persistence [15], workflow mismatches [16] and time consuming system demands [17–19] resulting in reduced face-to-face patient care [20] making EHRenabled collaboration troublesome and highly context dependent [21].”
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“The introduction of increasingly complicated technology into already complex work environments may trigger various unintended interactions that undermine or outweigh the potential benefits of the new technology [17].”
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“2,26 For outsiders looking in, it can be difficult to establish whether the approach adopted by an organisation has real potential for impact.”
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The Heimdall framework for supporting characterisation of learning health systems
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Measuring quality in the therapeutic relationship--Part 1: objective approaches
Greenhalgh, T., & Heath, I. (2010) · BMJ Quality & Safety · doi:10.1136/qshc.2010.043364 · Cited by 54
Self-citationCausal study of low stakeholder engagement in healthcare simulation projects
Jahangirian, M., Taylor, S. J. E., Eatock, J., Stergioulas, L. K., & Taylor, P. M. (2014) · Journal of the Operational Research Society · doi:10.1057/jors.2014.1 · Cited by 50
“As some evidence suggest that snowballing is a very effective literature search strategy (Greenhalgh and Peacock, 2005, Greenhalgh et al, 2009), we then adopted this strategy to search for closely related articles that would help to identify relevant causes.”
MethodUndertaking sociotechnical evaluations of health information technologies
Cresswell, K. M., & Sheikh, A. (2014) · Journal of Innovation in Health Informatics · doi:10.14236/jhi.v21i2.54 · Cited by 58
E-commerce performance in hospitality and tourism
Hua, N. (2016) · International Journal of Contemporary Hospitality Management · doi:10.1108/ijchm-05-2015-0247 · Cited by 57
Design of A GPS Monitoring System for Dementia Care and its Challenges in Academia-Industry Project
Wan, L., Müller, C., Randall, D. W., & Wulf, V. (2016) · ACM Transactions on Computer-Human Interaction · doi:10.1145/2963095 · Cited by 54
“ICT development for institutional care has explicitly concerned itself with issues of the coordination of workflow tasks in complex settings like hospitals, as with the introduction of Electronic Patient Record (EPR) [Greenhalgh et al. 2009; Boulus and Bjorn 2010].”
BackgroundBossen, C., Jensen, L. G., & Udsen, F. W. (2013) · Computer Supported Cooperative Work (CSCW) · doi:10.1007/s10606-013-9195-5 · Cited by 52
“Comprehensive overviews of studies on health care IT can be found in Greenhalgh et al. (2009) and Fitzpatrick and Ellingsen (2012).”
BackgroundTakian, A., Petrakaki, D., Cornford, T., Sheikh, A., & Barber, N. (2012) · BMC Health Services Research · doi:10.1186/1472-6963-12-105 · Cited by 51
“All this is to be achieved through, amongst other things, improved availability, completeness and legibility of patient records, standardization of care practices and more informed and timely clinical decision making [1-5].”
BackgroundMethodWalshe, N., Ryng, S., Drennan, J., O'Connor, P. E., O’Brien, S., Crowley, C. M., & Hegarty, J. M. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104086 · Cited by 66
Forsyth, S. R., Odierna, D. H., Krauth, D., & Bero, L. A. (2014) · Systematic Reviews · doi:10.1186/2046-4053-3-122 · Cited by 50
“Systematic reviews of qualitative research summarize and narratively synthesize results using a range of methods [8-10].”
BackgroundResponse to ‘The Appropriation of Complexity Theory in Health Care’
Greenhalgh, T., Plsek, P. E., Wilson, T., et al. (2010) · Journal of Health Services Research & Policy · doi:10.1258/jhsrp.2010.009158 · Cited by 50
Self-citationEthical questions must be considered for electronic health records
Spriggs, M. P., Arnold, M., Pearce, C. M., & FRY, C. L. (2012) · Journal of Medical Ethics · doi:10.1136/medethics-2011-100413 · Cited by 48
‘We can only request what's in our protocol’: technology and work autonomy in healthcare
Petrakaki, D., & Kornelakis, A. (2016) · New Technology Work and Employment · doi:10.1111/ntwe.12072 · Cited by 50
Morrison, Z., Fernando, B., Kalra, D., Cresswell, K. M., & Sheikh, A. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2013-001666 · Cited by 51
Ben-Zion, R., Pliskin, N., & Fink, L. (2014) · Information Systems Management · doi:10.1080/10580530.2014.958024 · Cited by 60
“Greenhalgh et al. (2009) found that while the EHR often slows down and frustrates the clinical encounter (primary use), it significantly accelerates secondary uses, such as audit and research of clinical data.”
BackgroundMethodInfluentialA framework for analysing learning health systems: Are we removing the most impactful barriers?
McLachlan, S., Dube, K., Johnson, O. A., Buchanan, D., POTTS, H. W. W., Gallagher, T., & Fenton, N. (2019) · Learning Health Systems · doi:10.1002/lrh2.10189 · Cited by 52
“27 Many commercial EHR solutions have proprietary and cost barriers to integration with other systems and sources of health data relevant to the individual patient.”
BackgroundSelf-citationAckerman, S., Sarkar, U., Tieu, L., Handley, M. A., Schillinger, D., Hahn, K., Hoskote, M., Gourley, G., & Lyles, C. R. (2017) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocx015 · Cited by 42
Healthcare information systems: the cognitive challenge
Lintern, G., & Motavalli, A. (2018) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-018-0584-z · Cited by 47
“Greenhalgh et al. [4] found no evidence that computerized information systems produce the anticipated healthcare benefits, while Greenhalgh and Stones [5] question the assumption of policymakers that such systems will improve quality, efficiency and safety.”
BackgroundMethodInfluentialCrime research in hospitality and tourism
Hua, N., Li, B., & Zhang, T. C. (2020) · International Journal of Contemporary Hospitality Management · doi:10.1108/ijchm-09-2019-0750 · Cited by 58
Transforming healthcare: policy discourses of IT and patient-centred care
Klecuń, E. (2015) · European Journal of Information Systems · doi:10.1057/ejis.2014.40 · Cited by 45
“Contrary to hopes, many EHR projects have not lead to the transformation of healthcare organizations (e.g., through supporting new ways of collaborative working) or to the realizations of expected benefits (Greenhalgh et al., 2009).”
BackgroundInfluentialThe impact of adopting EHRs: how losing connectivity affects clinical reasoning
Varpio, L., Day, K., Elliott-Miller, P., King, J. W., Kuziemsky, C. E., Parush, A., Roffey, T., & Rashotte, J. (2015) · Medical Education · doi:10.1111/medu.12665 · Cited by 45
Bélanger, E., Bartlett, G., Dawes, M. G., Rodríguez, C., & Hasson-Gidoni, I. (2012) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2012.07.008 · Cited by 47
“With over a decade of research behind us about the implementation of HIT in both acute and primary care settings [15], lessons should be drawn from the continued uncertainty of their impact, as we turn to the new, promising HIT currently being developed and implemented with PHR [16].”
BackgroundHow might the iPad change healthcare?
Marceglia, S. R. F., Bonacina, S., Zaccaria, V., Pagliari, C., & Pinciroli, F. (2012) · Journal of the Royal Society of Medicine · doi:10.1258/jrsm.2012.110296 · Cited by 43
Whipple, E. C., Dixon, B. E., & McGowan, J. J. (2012) · Informatics for Health and Social Care · doi:10.3109/17538157.2012.678451 · Cited by 45
Drinkwater, J., Stanley, N., Szilassy, E., Larkins, C., Hester, M., & Feder, G. S. (2017) · British Journal of General Practice · doi:10.3399/bjgp17x689353 · Cited by 43
Electronic Health Records and Quality of Diabetes Care
Koppel, R., Majumdar, S. R., & Soumerai, S. B. (2011) · New England Journal of Medicine · doi:10.1056/nejmc1111722 · Cited by 42
Cresswell, K. M., Sheikh, A., Franklin, B. D., Krasuska, M., Nguyen, H. T., Hinder, S., Lane, W., Mozaffar, H., Mason, K., Eason, S., et al. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05355-7 · Cited by 43
Self-citationInstitutional logics of the EMR and the problem of 'perfect' but inaccurate accounts
Pine, K. H., & Mazmanian, M. (2014) · ACM Conference on Computer Supported Cooperative Work (CSCW) · doi:10.1145/2531602.2531652 · Cited by 45
“For example, although EMR facilitates efficient data gathering for secondary purposes, efficiency of primary clinical care activities is simultaneously decreased [6,19].”
BackgroundInfluentialTraditions of research into interruptions in healthcare: A conceptual review
McCurdie, T., Sanderson, P., & Aitken, L. M. (2017) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2016.11.005 · Cited by 37
Metadata
- Authors
- GREENHALGH, T., POTTS, H. W. W., WONG, G., BARK, P., & SWINGLEHURST, D.
- Affiliations
- University College London (GB)
- Corresponding author
- GREENHALGH, TRISHA
- Venue
- The Milbank Quarterly
- Publisher
- Wiley
- Published
- 2009-12
- Volume
- 87
- Issue
- 4
- Pages
- 729-788
- ISSN
- 0887-378X (ISSN-L)
- 1468-0009
- PMC
- PMC2888022
- OpenAlex
- W2134384563
- Cited by
- 541
- References
- 223
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 18 · 2023: 17 · 2022: 19 · 2021: 27 · 2020: 44 · 2019: 55 · 2018: 35 · 2017: 33 · 2016: 42 · 2015: 32 · 2014: 58 · 2013: 32 · 2012: 36
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Milbank Quarterly (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RDA/03/07/076, CFHEP 007, CFHEP 002)
- Medical Research Council
- Service Delivery and Organisation Programme
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Nursing › Research and Theory › Nursing Diagnosis and Documentation
- Keywords
- electronic health records, health information technology, clinical decision-making, situated practice, sociotechnical networks, organizational context, implementation success, system size, paper records, research paradigms
- MeSH terms
- Diffusion of Innovation, England, Health Services Research, Hospital Information Systems, Humans, Risk Factors, MEDLINE, Medical Records Systems, Computerized, Access to Information
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-07, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-07 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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