The integration of EHR in IT infrastructures supporting organizations enable improved access and recording of patient data, enhanced ability to make improved decisions, improved quality and reduced errors in patient care. Despite these benefits, there are mixed results as to the use of EHR. 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. Following an analysis of qualitative data, collected in a case study at a hospital using interviews, this research explains how physicians interact with EHR. The key contribution of this research is in explaining how physicians interact with EHR in terms of concepts that are grounded in the real world experiences of physicians. The model of positive and negative physician work cycles is introduced and discussed. Contributions to research and practice are presented.