Electronic Health Record as a Generational Institutional Logic Arbitrer in an E-Health Ecosystem

Electronic Health Record Systems have become integral to health care. Although systems integration issues and privacy concerns remain, healthcare has embraced its use to support medical care. Physicians who transitioned from paper and file health records to electronic health records were accustomed to circumventing system restrictions toward health management when these restrictions were opposed to medical diagnostic, therapeutic, and care prescriptions. This article explores how electronic health records (EHRs) can enforce managerial institutional logic over medical diagnostic and therapeutic logic, impacting both experienced and new generations of physicians. It examines how system limitations in EHRs affect decision-making processes, mainly how earlier physicians may circumvent these limitations compared to newer generations who adhere more strictly to system constraints as a result of their lack of knowledge on how to use desktop systems, which is attested by a systematic literature review on digital literacy and skills of the Z and Y generations.