Adaptations of electronic health records to activate physicians' knowledge: How can patient centered care be improved through technology?

The United States of America is known for the rising costs of its healthcare and declining quality of care. While the push towards the integration of the healthcare information infrastructure is seen to be an important step towards addressing problem of the rising costs of healthcare and falling quality of care, the integration of EHR (Electronic Health Records), the central component of this infrastructure, remains a challenge. It appears that physicians are at the center of this bottleneck. The literature suggests that the reasons for the limited use relate to policy, financial and usability considerations, but it does not provide an understanding of reasons for physicians' limited interaction and adaptation of EHR. In this paper, we argue that in order to be able to use the technology to provide better healthcare, physicians need to be able to activate their knowledge through it. We investigate process of adaptations that physicians go through when trying to use electronic health records. Our findings indicate that physician's knowledge identities need to align with the functionalities made available through the technology. We draw upon the framework of knowledge activation in order to understand how physicians use their knowledge to provide better healthcare. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research shows how physician's adaptations of EHR activate their knowledge for the purpose of improving healthcare provision. The key contribution of this research is in discovering the ways in which physicians' adaptation of technology can enable knowledge activation.