Bibliographic record
Abstract
This paper provides analysis of a 3-year longitudinal ethnographic study following the gradual adaptation of an Electronic Medical Record (EMR) in a community health centre in Canada. Adopting a sociotechnical perspective, I follow the EMR and the work practices as they undergo continuous modifications and I identify changes that are brought about by the EMR. Findings from this research show essential differences between types of sociotechnical changes and their implications. I distinguish between the initial changes that occurred and their implications which I characterize as having straightforward, direct, and immediate effects; and the emergent changes and their implications which I characterize as being broader and having a deeper level of impact in the long term. Furthermore, I illustrate how some of these changes reflected realizations of the visions behind the dream of implementing an EMR; while other changes enabled new practices and illuminated issues that were invisible before. Finally, drawing upon insights from actor-network theory, I show how the EMR is becoming more than just a tool; it is participating in creating new practices and gradually transforming the medical profession.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.002 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".