Regulators of healthcare systems continue to investigate ways to improve continuity of care (COC) for patients given its inherent fragmented nature. Integrated healthcare information technology (HIT) system is touted as one of the ways to improve COC. Yet, studies show that there are still challenges in achieving effective COC even when supported by integrated HIT. These persistent challenges are likely due to deep-seated tensions among the various parts of the healthcare system that are involved in providing care. Drawing on HIT impact literature and paradox theory, we study the implementation of an integrated electronic medical record (EMR) system aimed at improving COC for the specialist referrals process in a hospital cluster. We found that while the system had positive impacts on some aspects of the COC, we uncover two types of paradoxical tensions occurring in this healthcare context that interfered with those positive impacts and contributed to ongoing COC challenges
