Table 2 Overview of facilitating and constraining influences of the EHR’s inscribed collaborative affordances

Portability

… accessibility of patient data, independent of location and medical context.

… digital sharing of patient data with health providers outside the hospital.

… integration of patient data from different specialties, resulting in a comprehensive overview.

...mutual understanding of patient data because of specialty- and discipline-specific user-interfaces.

Co-located access

… professionals viewing the same data from different locations.

… modifying health records and entering orders simultaneously (by different professionals).

… a comprehensive overview during multidisciplinary meetings because of a lack of desktops.

Shared overview

… integration and availability of patient information, avoids multiple data sources and handwritten notes.

… cognitively processing the overview. Information overload is experienced, due to the large number of notes and patient information not being presented in a chronological order.

… once-only registration (at the source) and full registration of activities through orders.

… generating a cross-specialty overview since patient data are specialty- and department- specific. Departments and specialties use medical history and problem lists in different ways, leading to incomplete files.

Mutual awareness

… hospital-wide working processes.

… obtaining an easy-to-use overview due to information overload and patient information not being presented in a chronological order.

… notification of results, quick updates.

… a shared awareness because patient data models are specialty- and department- specific.

Messaging

… discussing patients with other specialties without needing to refer them to the other specialties.

… face-to-face communication. The reduced need for face-to-face communication saves time but is experienced as reducing the collective responsibility for a smooth workflow.

… the replacement of other messaging systems.

… an easy overview due to message overload.

...uniform forms of communication.

Orchestrating

… efficient and shared working processes.

… flexible task distribution. Strict authorizations constrain flexible, multidisciplinary task distribution.

… the systematic registration of results.

… process efficiency due to a strict focus on orders.

… ad hoc, diverse forms of collaboration. The EHR system enforces system-supported forms of collaboration. Some multidisciplinary consultations are not supported by the EHR.