Assessment of a computerized medical record system: disclosing scripts of use

In the last two decades, empirical studies adopting a critical sociological approach to technology have shown how innovations are socially shaped, and how their introduction into human practices is often problematic. This paper describes how the Actor–Network Theory (ANT) can contribute to the evaluation of information technology. Results of the evaluation of a computerized medical record system implemented in four Quebec (Canada) hospitals are presented. The distribution of skills and tasks among nurses, physicians and managers (as implied by the design), and the use of the computerized medical record system proved highly problematic since they radically modified clinical practices. Theoretical and practical implications of using ANT as an evaluation framework are discussed.