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Objectives: The aim of this paper is to critically assess some of the underlying assumptions behind these initiatives and analyze the dominant expressions, forms and mechanisms of integration.

Methods: This paper employs a discourse analysis to elicit the notion of integration of information systems and its consequences for electronic patient record systems.

Results and Conclusions: An alternative strategy is outlined, encouraging a more decentralized, multi-vocal approach acknowledging the productive role of related and duplicated information and preserving the existing variety of information systems.