Supporting informality

Abstract

This paper reports findings from an ethnographic study of the work of Adult and Care of the Elderly Community Mental Health Teams in the context of the deployment of an Electronic Medical Record. Our findings highlight the importance of informal discussions and provisional judgments as part of the process by which teams achieve consensual clinical management decisions over time. We show how paper-based documentation supports this collaborative work by affording both the revision of preliminary clinical management options and the accretion of contributions by team members with different clinical perspectives and expertise. Finally, we consider the implications both for teamwork and the Integrated Care Record (ICR) as clinical documentation becomes increasingly held and distributed electronically.