  Computer-based information systems feature in almost every aspect of our
lives, and yet most of us receive handwritten prescriptions when we visit our
doctors and rely on paper-based medical records in our healthcare. Although
electronic health record (EHR) systems have long been promoted as a
cost-effective and efficient alternative to this situation, clear-cut evidence
of their success has not been forthcoming. An examination of some of the
underlying problems that prevent EHR systems from delivering the benefits that
their proponents tout identifies four broad objectives - reducing cost,
reducing errors, improving coordination and improving adherence to standards -
and shows that they are not always met. The three possible causes for this
failure to deliver involve problems with the codification of knowledge, group
and tacit knowledge, and coordination and communication. There is, however,
reason to be optimistic that EHR systems can fulfil a healthy part, if not all,
of their potential.
