The long-term objective of this K99/R00 career development grant is to improve the interaction between informatics tools and everyday clinical practice. A core premise of this project is that medication safety can be improved with informatics technologies that better support the safety-producing routines used by clinicians and patients. Phase 1 uses ethnographic work practice research to describe how nurses integrate new technology into everyday medication management work, and subsequent analysis of how medication safety is defined by nurses. Phase 2 uses ethnographic methods to understand the 'work' of medication management from the patient perspective. We will enroll Acute Coronary Syndrome patients in the inpatient setting and document their experiences related to medication management in the hospital, with the clinic and rehab, and at home. We hope to identify strategies for the establishment and maintenance of medication routines, and identify ways that informatics tools can assist in this work.