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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“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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“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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“However, there appears to be surprisingly little peer-reviewed research on how interpretivist approaches might be used proactively and explicitly to shape the effective implementation and use of EPR systems, especially in large-scale programs.”
§ 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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“Perhaps partly in response to this, the HIS literature has begun to move beyond studies restricted to measuring impact (“EPR on” versus “EPR off ”) and to address how context mediates and moderates this impact.”
§ 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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“The positivist literature effectively views context as a conglomeration of confounding variables, which must be either carefully quantified and modeled or controlled for in a RCT design.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Organizational Context
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“One key difference between two traditions that otherwise have much in common-technology-in-practice (meta-narrative 5) and ANT (meta-narrative 8)-is the treatment of the human agent.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR User
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“First, it has shown that humans can be very creative in overcoming the inherent limitations of technologies (“workarounds”).”
§ 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 Suchman 2007
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“Feminist studies have demonstrated that EPR designers have sometimes failed to understand or fully incorporate the work practices of female staff with relatively low status in the organization, especially frontline nurses.”
§ 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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“The studies consistently demonstrated that the sociotechnical network in which the EPR is embedded is typically highly dynamic and inherently unstable.”
§ 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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“The first tension is between “the EPR as tool or container” and “the EPR as actor.””
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
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“One of the most striking differences among the research traditions covered in this review is their treatment of context.The tension might be expressed as “context as the setting within which the EPR is implemented” and “context as the EPR-in-use””
§ 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
“Research traditions differ in their emphasis on the EPR's material properties.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > The EPR
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In the paper
“The idea that meaning is transmitted unproblematically along with data underpins many of the large-scale EPR programs currently under way (notably the National Programme for IT in England) (Department of Health 2008) and the plans for an extensive expansion of the IT infrastructure in the United States (Institute of Medicine 2009)”
§ 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 Department of Health 2008
- Not checked yetcites Institute of Medicine 2009
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In the paper
“Paper records, being flexible, portable, and tolerant of ambiguity, support the complex work of clinical practice remarkably well.”
§ 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
“In “failed” EPR projects, technical designers typically missed these subtleties and produced artifacts that fitted poorly with the situated nature of knowledge and the microdetail of clinical work practices.”
§ 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
“Different traditions in EPR research dispute the extent to which information placed on the EPR can be extracted from its context and transferred to a different context while still retaining its meaning.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
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“Researchers in these traditions do not see themselves as studying “technologies” and “contexts” separately but as studying technologies-in-use.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Organizational Context
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“There is a tension in the literature between a cognitive view of the human subject (the user is seen as an information processer or decision maker) and a relational view (the user is defined primarily by his or her position within a social or sociotechnical system).”
§ 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
“An important finding from these authors' work is that networked EPR systems are not unproblematically scalable.”
§ 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 Ellingsen and Monteiro 2003a
- Not checked yetcites Hanseth et al. 2006
- Not checked yetcites Monteiro 2003 source
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“CSCW studies have highlighted a telling paradox: that high-tech health care environments such as intensive care units often extensively use paper charts, white boards, sticky notes, and oral communication.”
§ 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
“(6) smaller, more local EPR systems may often (though perhaps not always) be more efficient and effective than larger ones.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
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In the paper
“In particular, some researchers (including our own group) have already begun to combine ANT with a more sophisticated theory of human agency (Greenhalgh and Stones 2009).”
§ 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 and Stones 2009
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“Much of the literature covered in this review suggests, conversely, that (1) the EPR may be alternatively conceptualized as an “itinerary,” “organizer,” or “actor”;”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
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In the paper
“(2) seamless integration of different EPR systems is unlikely because human work will always be needed to bridge the model-reality gap and recontextualize knowledge for different uses;”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
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In the paper
“The meta-narrative method has shown that “conflicting” findings in this large and heterogeneous literature can be fruitfully expressed as tensions and paradoxes relating to the nature of the EPR, the context in which it is implemented and used, and the way success in an EPR program is defined and pursued.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Conclusion
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In the paper
“The main tension here is between “success as objectively and prospectively defined” and “success as socially negotiated and context specific.””
§ 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
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In the paper
“This tension might be expressed in terms of the “logic of determinism” versus the “logic of opposition” (Robey and Boudreau 1999).”
§ 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 Robey and Boudreau 1999
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In the paper
“In some cases, this led to scholarly interdisciplinary research, higher-order insights, and the emergence of new paradigms (Ellingsen and Monteiro 2003b;Fox 1999;Østerlund 2004b).”
§ 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 Ellingsen and Monteiro 2003b
- Not checked yetcites Fox 1999
- Not checked yetcites Østerlund 2004b
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In the paper
“It is striking that many of the alternative approaches to research on the EPR in organizations uncovered in this review have developed in parallel rather than in dialogue with one another.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
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In the paper
“We also found, however, that some researchers explicitly made links with other communities and used their concepts and theories.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
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In the paper
“The interpretivist, critical, and recursive traditions problematize the very notion of success in an EPR project or program (e.g., it will be defined differently by different stakeholders) (Berg 2001;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 Berg 2001
- Not checked yetcites Klecun and Cornford 2005
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“These traditions also recognize that the most immediate and easily measurable impacts of a new EPR system (such as more time needed to enter data or frustrations stemming from the model-reality gap) may fail to capture more subtle or distant potential benefits (such as the easier and more reliable production of aggregated data or greater capacity for research).”
§ 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.
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In the paper
“The CSCW, technology-in-practice, and ANT literatures all offer evidence that clinical data must be interpreted in context and “framed” before they become meaningful.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Clinical Work and Knowledge
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“(4) the EPR may support, but will not drive, changes in the social order of the workplace;”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
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In the paper
“But we also found recent evidence that if EPR systems are developed organically and in-house, scale per se may not be a bar to their success.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Discussion and Recommendations
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In the paper
“Studies from both inside and outside the health informatics tradition, for example, are raising questions about both the scalability and the transferability of EPR systems, especially when such systems are developed commercially rather than grown organically as part of an emergent change effort (Shekelle and Goldzweig 2009).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Conclusion
What the sources say
- Not checked yetcites Shekelle and Goldzweig 2009
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In the paper
“These contrasts partly explain the low adoption and slow spread of the EPR in many health care settings.”
§ 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
“Researchers in the change management tradition are usually upbeat about the benefits of the EPR but assume that these will be realized only if the change process is properly managed (Heeks, Mundy, and Salazar 1999;Kaplan et al. 2001;Lorenzi et al. 2008).”
§ 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
What the sources say
- Not checked yetcites Heeks, Mundy, and Salazar 1999
- Not checked yetcites Kaplan et al. 2001
- Not checked yetcites Lorenzi et al. 2008
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“The preponderance of small studies with methodological flaws and positive outcomes in the early HIS literature raises the possibility of publication bias”
§ 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
“So far, then, the EPR has not been an “occasion for structuring” in any simple sense.”
§ 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
“A recent systematic review of 183 primary studies, for example, related the impact of EPR systems to contextual variables (Shekelle and Goldzweig 2009).”
§ 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
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In the paper
“The data pointed to a significant difference in the likelihood of success between local “homegrown” EPR systems (developed in an ad hoc way by clinicians close to the operational detail of key work practices) and “off the shelf ” systems (developed as either commercial products or public-sector systems of choice).”
§ 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
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In the paper
“In IS research overall, the literature is dominated by the former and is characterized by hypothesis-driven designs predicated on what are sometimes called variance models (DeLone and McLane 1992;Sabherwal, Jeyaraj, and Chowa 2006).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Meta-narrative 3: Information Systems (Positivist Approaches)
What the sources say
- Not checked yetcites DeLone and McLane 1992
- Not checked yetcites Sabherwal, Jeyaraj, and Chowa 2006
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In the paper
“Third, CSCW researchers have recognized two potentially conflicting work processes: immediate clinical care (primary uses) and tasks such as audit and research that are one step removed from the clinical encounter (secondary uses) (Heath and Luff 1996;Symon, Long, and Ellis 1996).”
§ 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 Heath and Luff 1996
- Not checked yetcites Symon, Long, and Ellis 1996
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In the paper
“This approach to context must overcome the challenge of repeating decomposition, that is, the sheer impossibility (especially in the highly complex field of health care) of incorporating anything approximating the fine-grained detail of the numerous contextual variables into the analysis (DeSanctis and Poole 1994).”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Organizational Context
What the sources say
- Not checked yetcites DeSanctis and Poole 1994
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In the paper
“Although it is tempting to present the mainstream (traditionally positivist) biomedical literature as incommensurable with, and perhaps philosophically less sophisticated than, studies written from interpretivist, critical, and recursive positions, the latest evidence suggests a less polarized picture.”
§ Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method > Conclusion
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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
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“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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In the paper
“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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In the paper
“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
plain- Asserted: passes — The authors put it forward as true.
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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 paper
“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)
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
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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
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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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
plain- Asserted: passes — The authors put it forward as true.
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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
plain- Asserted: passes — The authors put it forward as true.
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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)
plain- Asserted: passes — The authors put it forward as true.
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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)
plain- Asserted: passes — The authors put it forward as true.
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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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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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)
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
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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
plaindirect- Asserted: passes — The authors put it forward as true.
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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
plain- Asserted: passes — The authors put it forward as true.
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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
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
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
plain- Asserted: passes — The authors put it forward as true.
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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
plain- Asserted: passes — The authors put it forward as true.
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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
“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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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 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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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
“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
plain- Asserted: passes — The authors put it forward as true.
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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
“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)
plaindirect- Asserted: passes — The authors put it forward as true.
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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
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“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
plain- Asserted: passes — The authors put it forward as true.
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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
“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.
- 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
“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].”
Citations
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The Structure of Scientific Revolutions
Kuhn, T. S., & Schlegel, R. (1963) · Physics Today · doi:10.1063/1.3050879 · Cited by 35,538
Situated Learning: Legitimate Peripheral Participation
Lave, J., & Wenger, E. (1991) · Cambridge University Press eBooks · doi:10.1017/cbo9780511815355 · Cited by 35,324
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Evidence based medicine: what it is and what it isn't
Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996) · BMJ · doi:10.1136/bmj.312.7023.71 · Cited by 15,769
Gioia, D. A., Mehra, A., & Weick, K. E. (1996) · Academy of Management Review · doi:10.2307/259169 · Cited by 15,616
Wallace, A. F. C., & Garfinkel, H. (1968) · American Sociological Review · doi:10.2307/2092245 · Cited by 12,413
Information Systems Success: The Quest for the Dependent Variable
DeLone, W. H., & McLean, E. R. (1992) · Information Systems Research · doi:10.1287/isre.3.1.60 · Cited by 10,697
THE STRUCTURE OF SCIENTIFIC REVOLUTIONS
McGuire, J. E. (1963) · Philosophical Books · doi:10.1111/j.1468-0149.1963.tb00813.x · Cited by 8,547
Institutions and organizations
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Research works printed but not linked: 12
- Aderibigbe A. L.Brooks andK.McGrath.2007.Electronic Patient Records and Nurses’ Work: Rhetoric and Reality.Paper presented at fifth Critical Management Studies conference Manchester Business School July 11–13 2007 Manchester. Available athttp://www.mngt.waikato.ac.nz/ejrot/cmsconference/2007/proceedings/criticalthinking/mcgrath.pdf(accessed September 29 2009).
- Berg M., 2000, Proceedings of the IFIP Working Group 8.2 Conference, 487
- Davidson E. andJ.Reardon.2005.Organizing Visions for IT Healthcare: Analysis of Discourse Surrounding Electronic Health Records.Paper presented at Academy of Management Conference August 9 Honolulu .
- Department of Health, 2008, The NHS Informatics Review Report
- Desjardins G.A., 2006, La résistance des utilisateurs face aux TI: Un processus de “sensemaking
- Eason K., 2009, A Case Study of Local Socio‐technical Systems Design within the NPfIT Programme
- Garfinkel H., 1967, Studies in Ethnomethodology
- Institute of Medicine, 2009, Health and Human Sciences in the 21st Century: Charting a New Course for a Healthier America
- Jaeger J.F., 2005, Proceedings of Continuity of Care, HelsIT
- 10.2307/256817 · DOI
- Rodriguez C., 2006, APROS 11: Asia‐Pacific Researchers in Organisation Studies, Eleventh International Colloquium, 306
- Shekelle P.G., 2009, Costs and Benefits of Health Information Technology: An Updated Systematic Review
Cited by
Sorted by citations
The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview
Black, A. D., Car, J., Pagliari, C., Anandan, C., Cresswell, K., Bokun, T., McKinstry, B., Procter, R., Majeed, A., & Sheikh, A. (2011) · PLoS Medicine · doi:10.1371/journal.pmed.1000387 · Cited by 1,442
“An additional 55 supplementary reviews provided context to the findings [68–122], aiding in their interpretation [123].”
BackgroundPluye, P., & Hong, Q. N. (2014) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-032013-182440 · Cited by 1,363
Supporting thinking on sample sizes for thematic analyses: a quantitative tool
Fugard, A. J. B., & POTTS, H. W. W. (2015) · International Journal of Social Research Methodology · doi:10.1080/13645579.2015.1005453 · Cited by 778
Self-citationRAMESES publication standards: meta-narrative reviews
Wong, G., Greenhalgh, T., Westhorp, G., Buckingham, J., & Pawson, R. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-20 · Cited by 610
“” [17]”
Self-citationA Review of 25 Years of CSCW Research in Healthcare: Contributions, Challenges and Future Agendas
Fitzpatrick, G., & Ellingsen, G. (2012) · Computer Supported Cooperative Work (CSCW) · doi:10.1007/s10606-012-9168-0 · Cited by 439
“These can be especially useful for secondary purposes such as management, strategic planning, accountability and epidemiological research (Berg 1999; Greenhalgh et al. 2009; Hardstone et al. 2004) however the primary delivery of patient care can be impacted because of the disparity between formal…”
BackgroundInfluential
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.
What counts as a claim ›How we measure confidence ›How we check this ›
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