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The research took place over a five year period and included four major integrated systems implementations within three Hospitals in the North East of England. The paper focuses on the final implementation where the hospital (Hospital Z) wanted to integrate both the manual and computer systems within the department of Gynaeoncology with the hospital centralised computerised systems. The first section of the paper provides an overview of the theory that has informed the study. The second section comprises the research methodology and fieldwork undertaken within the hospital. The third section takes a reflexive approach to the discussion of the empirical material and finally the fourth section draws some conclusions on carrying out critical research for the participants and researcher.