‘What are they saying?’ Examining healthcare field discourses in West Tennessee

An important step towards superior healthcare management is meaningful use of the electronic health record (EHR) systems which can be facilitated through the use of Direct technology by the healthcare providers. Contrary to expectations, the usage of Direct technology is not wide-spread. This article seeks to understand the underlying causes by using discourse analysis of qualitative data collected in West Tennessee region. An inductive data analysis to construct discourses both before and after the attempts to encourage the technology among the promoters, the supporters, and the providers reveals that most actors were initially quite positive and hopeful about the technology; however, by the end of the statewide rollout, many of them got disenchanted with Direct technology. Some of the issues perceived by various actors in the field comprised of the inability to integrate the state offered technology with their EHRs, unplanned and rushed rollout, and lack of post-rollout support.