1. EHR technology is sold to managers, not clinicians.
2. The leadership of introducing the EHR is fragmented and highly dependent on local conditions such that success in one location does not guarantee success in another location. Likewise with failure.
3. Researchers have a tendency to treat evaluation of health technology as epistemologically equivalent to evaluation of pharmaceutical technology even though a cursory examination of the logic underpinning this assumption clearly demonstrates that this is not the case.
(point 3 makes my job very difficult and political. Fortunately this work[1] and the very few others like it, generally from the same research group lends my work instant legitimacy. Without it, getting my thesis through the committie would I fear be impossible).