While technical challenges persist in health information systems, many of these implementations fail because oforganizational issues. A major criticism of health information systems, which include electronic health records (EHR) andcomputerized physician order entry (CPOE), is that their underlying model is too simplistic and does not reflect thecomplexity and fluidity of healthcare practice. This has led to systems that cannot adequately support the dynamic andcontingent nature of clinical work or facilitate communication and collaboration among clinicians. Studies of unexpectedconsequences of EHR implementations reveal social and political impacts, and that many contextual factors are not wellunderstood or their importance underemphasized. Using a before-and-after observational study design and adopting thesociotechnical systems perspective, this study analyzes impacts of an EHR on clinician workflow, time allocation andcommunication, and provides useful insight into how such systems affect user work activities, thereby informing futurehealth information system adoptions and implementations.