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This paper examines the factors that made services more or less effective in using electronic patient record systems to produce clinical information for clinical audit and research.

Case studies of the use of electronic patient record systems in three maternity services in England, using qualitative research methods (semi‐structured interviews, observations and shadowing).

There were many contributing factors in each case site. The three main groups of determining factors were these: the resources devoted to, and acceptability to midwives of, the “IT midwife”; maternity managers prioritisation of information related matters; the relationship of maternity information systems with Trust‐wide systems.

Provides services with lists of factors they need to consider if they want to maximise the benefits realised for clinical audit and research from existing and new electronic patient record systems.