Digital libraries (DLs) are major advances in information technology that frequently fall short of expectations [7, 28]. Covi & Kling [7] argue that understanding the wider context of technology use is essential to understanding digital library use and its - plementation in different social worlds. Recent health informatics research also - gues that social and organisational factors can determine the success or failure of healthcare IT developments [8, 11, 12]. Heathfield [11] suggests that this is due to the complex, autonomous nature of the medical discipline and the specialized (clinician or software engineer) approach to system development. Negative reactions to these systems is often due to inappropriate system design and poor implementation. H- ever, there may be other less obvious social and political repercussions of information system design and deployment. Symon et al [26] have identified, within a hospital scenario, how social structures and work practices can be disrupted by technology implementation. Although these systems often deal with sensitive, personal infor- tion, other system design research has found that apparently innocuous data can be perceived as a threat to social and political stability [1,2,3]. To understand the impact of DLs within the medical profession, an in-depth evaluation is required of the int- duction and later development of these applications within their specific social and organisational settings. However, as Covi & Kling [7] have highlighted, there are few high-level theories that aid designers in understanding the implication of these issues for DL design and implementation.