title: Dilemmas, tetralemmas, reimagining the electronic health record.
abstract: With the transition from paper-based to computer-based records, nursing practice shifts to computerized documentation of care in the electronic health record (EHR). Viewed not only as an electronic document, but as an instrument of modern economic and technological ideology that serves organizational goals of cost-efficiency, the EHR can be perceived as creating a dilemma for a patient-centered nursing practice. Viewing the EHR as relying solely on the use of standardized languages begets a number of questions and furthers the dilemma for nurses. Through a discussion that draws on the Indian tradition of the tetralemma, authors transcend the EHR/nursing dilemma.
authors.affiliation: School of Nursing, University of Victoria, Victoria, British Columbia, Canada. olgawelt@gmail.com
authors.forename: Olga
authors.initials: O
authors.lastname: Petrovskaya
authors.forename: Marjorie
authors.initials: M
authors.lastname: McIntyre
authors.forename: Carol
authors.initials: C
authors.lastname: McDonald
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003220:Conflict, Psychological; D034462:Dissent and Disputes; D004282:Documentation / Q000379:methods* / Q000639:trends; D004645:Empathy; D055318:Evidence-Based Nursing; D006694:Holistic Health; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D009723:Nurse-Patient Relations; D009733:Nursing Diagnosis; D048108:Nursing Informatics; D009737:Nursing Records; D009936:Organizational Innovation; D018802:Patient-Centered Care; D010687:Philosophy, Nursing; D013673:Technology Assessment, Biomedical; D013850:Thinking; D018875:Vocabulary, Controlled; D015013:Yoga