From “Rules to Interpret” to “Rules to Follow”: ePrescription in Greece

Abstract

This paper aims to contribute to the on‑going discourse on how to design and introduce governance technology for highly reliable professional work within healthcare. With this aim, we study the Greek ePrescription initiative. The empirical data used in this paper were collected over a nine month period from three different pharmacies implementing the new ePrescription platform. The analysis of data led to the identification of tensions between the established way of performing work (which was based on professionalism and discretion) and the new way imposed by ePrescribing (which is based on activity control and monitoring). Pharmacists traditionally interpreted rules in the light of knowledge, practice/habitude and contextual specificities but with ePrescribing the rules are solidified. From “rules to interpret” they turned to “rules to follow”. The tensions are currently resolved by pharmacists with the employment of workarounds. We view workarounds as indications of incongruence between technology and task that can be productively used for design improvement. Furthermore, we attempt to generalise the case‑specific insights by linking redesign recommendations to the concepts of usability, tailorability, and generativity of information systems.