As healthcare becomes increasingly digital, electronic medical records are transforming how patient information is documented, accessed and managed. In recently published research, Prof. Ayushi Tandon of Trinity Business School, Trinity College Dublin, and co-author Prof. George Kandathil, IIM Ahmedabad explore how women experience these systems beyond their clinical purpose. Their work reveals that while electronic medical records capture medical histories, they do not always capture the everyday realities in which health is lived.

Beyond the Medical Record: Into the realities of patients’ daily lives by CoBS Editor Mallika Rahane.

Related research: Tandon, A., & Kandathil, G. (2025). Women patients’ experiences with electronic medical records: a ‘Jeevan Yapan’ perspective. Information Technology for Development, 31(4), 1695–1722. https://doi.org/10.1080/02681102.2025.2521278

Electronic medical records (EMRs) have become an increasingly familiar part of healthcare systems around the world. They organise medical histories, laboratory reports, prescriptions and clinical notes into digital records that can be accessed quickly by healthcare professionals. For hospitals and policymakers, they promise greater efficiency, improved continuity of care and better clinical decision-making.

Yet, despite decades of research on EMRs, one perspective has remained surprisingly underexplored: that of the patient. Drawing on eight months of ethnographic fieldwork on 52 patients across four healthcare organisations in India, Prof. Ayushi Tandon and her co-author examine how women experience electronic medical records and what those experiences reveal about the relationship between digital technology and everyday life.

More than a digital file

For many of the women in the study, electronic medical records represented confidence in the healthcare system. They trusted digital records to preserve their medical history accurately, allow doctors to retrieve previous consultations with ease and support more consistent treatment over time. Several participants viewed hospitals using computers as more organised and more reliable, while others appreciated that doctors no longer had to depend solely on memory or handwritten files.

Medical records also influenced how women spoke about their own health. Instead of describing symptoms in everyday language, many adopted the medical terminology they encountered during consultations. Diagnoses, prescriptions and treatment plans gradually became the framework through which they interpreted their own experiences. In this sense, the electronic record did not merely document healthcare; it also shaped how healthcare was understood.

The researchers do not challenge these benefits. Rather, they argue that they tell only part of the story.

Beyond the clinic

The central contribution of the paper lies in an indigenous concept the authors describe as Jeevan Yapan.

The researchers observed that women’s understanding of the digitalization and health needs is shaped not only by biomedical structures but also by social structures. These social structures influence the mundane activities, practices, and local knowledge that constitute women’s everyday lives.

Rather than referring simply to health or illness, Jeevan Yapan encompasses these ordinary and mundane realities through which people live their lives: family relationships, household responsibilities, cultural traditions, financial circumstances, local knowledge and everyday routines.

These realities repeatedly surfaced during consultations. Women discussed caring responsibilities, food customs during pregnancy, transport difficulties, work schedules and conversations with family members. Such factors often influenced whether medical advice could realistically be followed.

However, these aspects of life rarely found a place within the electronic medical record itself.

The result was not necessarily inaccurate documentation. Instead, it was an incomplete picture. The biomedical aspects of health were carefully recorded, while the circumstances shaping patients’ ability to manage that health frequently remained outside the digital system.

When one system meets many realities

The research illustrates this tension through numerous examples drawn from the fieldwork.

Some women asked doctors to write specific recommendations that they could show to mothers-in-law or other family members, particularly during pregnancy, to support medical advice about rest or nutrition. Others explained that prescribed diets conflicted with long-standing household traditions or religious practices. Women from rural areas sometimes struggled to follow treatment plans because repeated journeys to hospital imposed financial costs that were difficult to absorb.

Likewise, the structured timelines embedded within medical records did not always align with how participants organised their daily lives. Clinical follow-up dates relied upon biomedical calendars and terminology, whereas some women naturally remembered important events through local festivals or community markers instead.

None of these issues questioned the value of electronic records themselves. Rather, they revealed the limits of a system designed primarily around clinical information when healthcare unfolds within far more complex social settings.

The experiences that remain invisible

The study also highlights forms of knowledge that are difficult to fit into standardised digital categories.

Women often shared practical concerns with their doctors that extended well beyond diagnosis or treatment. They discussed local customs after childbirth, food prepared by older family members, financial limitations affecting medication, or responsibilities that made prescribed rest almost impossible.

Doctors frequently responded to these conversations during consultations. Yet much of this exchange remained absent from the electronic record because it did not fit within the predefined biomedical structure of the system.

As such, an important distinction emerges. Healthcare consultations often recognised patients as individuals living within families and communities, whereas electronic records primarily represented them as clinical cases.

The gap between these two perspectives forms the heart of the paper.

Digital records and social realities

Perhaps the most sensitive findings concern stigma.

Several participants described feeling uneasy about the digital documentation of certain reproductive or sexual health issues. Unmarried women, in particular, worried about how information relating to their reproductive health might later be interpreted within families or future marriages. Others expressed concerns about who might gain access to digital records or associated communications.

Interestingly, the women did not reject electronic records outright. Many acknowledged their importance and valued the continuity of care they provided. Instead, they questioned whether standardised documentation always reflected the realities of their lives and whether they retained sufficient control over highly personal information.

The researchers argue that these experiences reveal how digital systems can unintentionally reproduce broader social challenges rather than remaining neutral tools for clinical documentation.

Designing with everyday life in mind

The paper moves beyond identifying problems and considers what more inclusive digital health systems might look like.

Rather than focusing solely on improving technical efficiency, the authors argue that designers and healthcare practitioners could pay greater attention to patients’ Jeevan Yapan. This means recognising that people are not defined exclusively by diagnoses or laboratory results. They also possess practical knowledge about the circumstances in which treatment takes place.

Accordingly, the researchers suggest that patients and their caregivers should not be viewed simply as recipients of digital healthcare, but as valuable contributors whose lived experiences can inform how such systems evolve. In this way, the design of electronic medical records becomes not only a technical exercise but also a question of accountability to the communities they serve.

Looking beyond the record

Although the research focuses on electronic medical records within women’s healthcare in India, its broader contribution reaches further. Increasingly, digital systems shape access to healthcare, education, finance and public services across many societies. All of these systems depend upon structured information. Yet every structure inevitably leaves something outside its boundaries.

Prof. Ayushi Tandon and her co-author invite readers to consider what those omissions might mean. Better technology does not necessarily require recording more information. Sometimes it begins by recognising that not everything important can be reduced to predefined fields or clinical categories.

Ultimately, the study offers a simple but thought-provoking reminder. Healthcare may be documented through electronic records, but it is lived through everyday experience. Understanding both may be essential if digital health is to become genuinely patient-centred.

The essence of Jeevan Yapan as a concept is encapsulated in the lines from a Chinese poem (translated), as quoted in The Janta Rural Health Scheme Philosophy (Griswold et al.,2018; Narayan, 2020)10:

Useful links:

• Link up with Profs. Ayushi Tandon and Kandathil George on LinkedIn
• Related article: Healing with Intelligence: AI, humans, and the pursuit of the common good in healthcare
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