A socio-technical study of an ubiquitous CPOE-system in local use

A socio-technical approach was used to study the qualitative effects of deploying a medication-CPOE (Computer-based Provider Order Entry System) at two internal medical wards on a hospital in Denmark. Our results show spatial and temporal transformations of core acts in medication work, transformation in competencies, and less time spent at the bedside for nurses and doctors, as a system--constructed for ubiquitous drug-order entries and handling--was implemented for local use. This study throws light on problems of patient continuity, patient-related and IT-system-related error-handling and time spend on core activities--when ubiquitous IT is used locally in a real physical setting with specific traditions of doing medication acts. The paper argues for the project organization to support the local renegotiation of time and place of programs of (work-)action and of collaboration with 'ubiquitous' CPOE-systems, as well as set up feed-back for maturation of software for future clinical use.