and c) Social factors, which comprise changes the new system will be making to current work practices of the users, and how users will engage with the system comprehensively.
We sought to understand how England's centrally procured and delivered EHR software was integrated within the work practices of users in selected secondary and specialist care settings.
National TB strain typing services have been introduced in other countries [ 17– 20], but the knowledge, attitudes and practices of users have not been evaluated.
As a first step, we need to explore the knowledge, attitudes and practices of users of gemstone therapeutics to see whether it warrants scientific evaluation based on prevalence alone.
In doing so, barriers such as difficulties integrating the new software into work practices of users can be identified.
In order to gain an insight into the more informal work practices of users, interviews were complemented by a mixture of object/activity/person-oriented observations of the software in use with on-site questioning, where appropriate and convenient.
In doing so, our focus was on the active impact of the new technology on work practices of users, as it was beginning to replace established paper processes in the organisations.
By investigating both the practice of methotrexate users, and the design of the system that supports methotrexate use, additional problems were observed across the healthcare system, meaning that the function of medicines packaging in ensuring safety may be even more critical than first suspected.
We contend that new technologies and new techniques for manipulating them have to be translated into the pre-existing knowledge and working practices of user communities before they can be effectively employed.
Revision and enforcement of the national guidelines to improve the behaviour and practice of both users and providers are necessary.
