Politicians and hospital management in Sweden and Denmark focus on IT and especially Electronic Patient Record, EPR as a tool for changes that will lead to better economy as well as better quality and service for the patients. These changes are not direct effects of the new medium for patient records but indirect effects due to the possibilities embedded in the new technology. This paper describes how clinicians as well as management in two hospitals interpret and uses the EPR. The findings clearly show that the intended changes i.e. the objectives for the implementation, never occurred. The interpretation of the interviews makes it possible to understand that one of the reasons is the lack of correlation between the conception and use of the EPR on one hand and the fact that the management and the clinicians do not share the same vision and mental picture of the future organization on the other.