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Objectives: This paper aims to describe and interpret the implementation of a hospital information system in a large UK hospital.

Methods: The paper is based on a longitudinal case study over a three-year period in which a cross section of hospital staff involved with the information system were interviewed.

Results and Conclusions: Ambitious government targets for the use of Information Technology in the UK National Health Service sit alongside a history of notable project failures. The decision by a UK hospital to install an advanced, integrated electronic patient record system therefore faced conflicting demands and expectations. This paper suggests that its simple categorisation as either a success or failure is problematic. Rather, the differing viewpoints that lead some clinicians to express “disappointment” with its performance, while others described its features as “tremendous” and managers suggested that …