Why Electronic Patient Record Systems in Hospitals Can Go Wrong

A Systems Failures Study
  • Joyce Fortune
  • Geoff Peters
  • Roger Stewart
  • Bill Dodd


Over recent years, in various countries, many attempts have been made to develop electronic patient record systems for use in acute hospitals. Although the investment in such schemes has been high, evidence from the international literature appears to indicate that they have tended to be less than wholly successful. Expectations have not been met, and their introduction has typically been accompanied by varying degrees of disaffection on the part of certain key players. Whittome (1993), for example, states: “Despite significant technological advances over the past few years, manual paper-intensive systems have remained basically unchanged. Computer systems are fragmented and require multiple data entry points.” Young (1994) agrees: “Over the years many different computer-based medical-record systems have been developed. Few, if any, have had more than temporary success.”


Acute Hospital Electronic Patient Record Clinical Information System Wide System Electronic Patient Record System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Campbell, J.R., Givner, N., Seelig, C.B., Greer, A.L., Patil, K., Wigton, R.S. and Tape, T., 1989, Computerized medical records and clinic function, M.D. Computing 6: 282–287.Google Scholar
  2. Carey, T.S., Thomas, D., Woolsey, A., Proctor, R., Philbeck, M. Bowen, G., Blish, C, and Fletcher, S., 1992, Half a loaf is better than waiting for the bread truck, Archives of Internal Medicine 152: 1845–1849.CrossRefGoogle Scholar
  3. Clayton, P.D., Pulver, G.E., and Hill, C.L., 1994, Physician use of computers: is age or value the predominant factor?, AMIA 301-305.Google Scholar
  4. Fortune, J., and Peters, G., 1990, The Formal System Paradigm for studying failures, Technology Analysis & Strategic Management 2: 383–390.CrossRefGoogle Scholar
  5. Fortune, J., and Peters, G., 1995, “Systems and Failures” in press, John Wiley & Sons, Chichester.Google Scholar
  6. Massaro, T. A., 1993, Introducing physician order entry at a major academic medical center, Academic Medicine 68: 20–30.CrossRefGoogle Scholar
  7. McDonald, C.J., Tierney, W.M., Overhage, J.M., Martin, D.K., and Wilson, G.A., 1992, The Regenstrief Medical Record System: 20 years of experience in hospitals, clinics, and neighbourhood health centers, M.D. Computing 9: 206–217.Google Scholar
  8. Rind, D.M., and Safran, C., 1994, Real and imagined barriers to an electronic medical record, AMIA 74-78.Google Scholar
  9. Sears Williams, L., 1992, Microchips versus stethoscopes: Calgary hospital, MDs face off over controversial computer system, Canadian Medical Association Journal 147: 1534–1547.Google Scholar
  10. Stewart, R., 1991, The use of social paradigms in the analysis of team behaviour during organizational change, in: “Systems Thinking in Europe”, Jackson, M.C., Mansell, G.J., Flood, R.L., Blackham, R.B. and Probert, S.V.E. eds., Plenum Press, New York.Google Scholar
  11. Whittome, H., 1993, Overview of electronic health record (EHR), Medical Records Institute 1: 13–15.Google Scholar
  12. Young, D., 1994, Consultants’ views on their use of a computer-based medical record system, in: Proceedings of Healthcare Computing 1994 217-222.Google Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Joyce Fortune
    • 1
  • Geoff Peters
    • 1
  • Roger Stewart
    • 2
  • Bill Dodd
    • 3
  1. 1.The Open UniversityMilton KeynesUK
  2. 2.Kingston UniversityKingston on Thames, SurreyUK
  3. 3.NHS ExecutiveLeedsUK

Personalised recommendations