We present in this thesis the results of a qualitative study based on two programs (Hopital Manager and CURSUS 3),located at the clinic La Sagesse of Rennes; this study aims to emphasize the communicative challenges posed by thesetools in clinical practice.Those tools are now considered as devices for modernization, rationalization, change of practices, and interactions between the patient, the doctor and caregivers. Thus, our goal is to show that in addition to technical issues, managerial, political and economic factors that are identified by many researchers, they are also challenges in terms of communication.The questions we will raise, from the point of view of research in Information Sciences and Communication, deal with rationalization process, and will be part of an issue related to organizational change, information traffic or standardization practices. Considering these concerns, technology deduces any reasoning from one premise, the one of performativity in organizations. What we choose to select in Orlikowski’s work has to do with the fact that what matters, in order to evaluate the effectiveness and performance of technology, is not technological artifact, but technologies in practice (Orlikowski, 2000). Thus, our goal is to show that the integrative medical discourse is a performative utterance based on communication patterns
