Inter-organisational use of the electronic health record in mental health

Abstract

The creation and use of electronic records in welfare services is a subject that has received widespread attention. The electronic health record (EHR) is used by different stakeholders (NGOs, hospitals, health care clinics and commissioning agencies) and thus enables the distribution and sharing of recorded information between them, and in this article we focus on the tensions that arise from the inter-organisational use of the EHR in the context of mental health services. The data corpus consists of four focus group interviews from three NGOs in Finland, and we draw on ethnomethodology to analyse the ways in which mental health workers together talk and make sense of these tensions in their interview talk. Our findings suggest that the EHR addresses concerns about the dislocation of clients and continuity of care, which create a need for mental health workers to trace clients' service use and also the contributions by other professionals. However, the introduction of the EHR has increased the recording work of mental health workers as well as of the monitoring of their work performance. Our findings strengthen the case for more transparent practices and rules of recording and information sharing among the different users of the EHR.