Implementing electronic health records: Key factors in primary care.

OBJECTIVE To examine common themes about implementing and adopting electronic health record (EHR) systems that emerged from 3 separate studies of the experiences of primary health care providers and those who implement EHRs. DESIGN Synthesis of the findings of 3 qualitative studies. SETTING Primary health care practices in southwestern Ontario and the Centre for Studies in Family Medicine at The University of Western Ontario in London. PARTICIPANTS Family physicians, other primary health care providers, and the Deliver Primary Healthcare Information management and operations team. METHOD The findings of 3 separate qualitative studies exploring the implementation of EHRs were synthesized. In the 3 studies, investigators used semistructured interview guides to conduct one-on-one interviews and a focus group, which were audiotaped and transcribed verbatim, to collect information about participants' experiences implementing and adopting EHRs. Transcripts were coded and analyzed by 1 or 2 investigators, and the research team met regularly for synthesis and interpretation of themes. MAIN FINDINGS Four common themes arose from the 3 studies: expectations of EHRs, time and training required to implement and adopt the software, the emergence of an EHR champion or problem solver, and the readiness of health care providers to accept the system. CONCLUSION Those considering implementing and adopting EHRs into a family practice environment should reflect on the following issues: their expectations of the system and what is needed to use the software, the level of commitment to EHR implementation and adoption, the availability of someone willing to take a leadership or champion role, and how much knowledge of computers potential EHR users have.

[1]  M. Patton Qualitative research and evaluation methods , 1980 .

[2]  C. K. Barsukiewicz,et al.  Electronic medical records: are physicians ready? , 1999, Journal of healthcare management / American College of Healthcare Executives.

[3]  Ida Sim,et al.  Electronic Medical Records: Lessons from Small Physician Practices , 2003 .

[4]  B. Gamble Barriers to Implementation of Clinical Systems , 2003 .

[5]  M H Ebell,et al.  What can technology do to, and for, family medicine? , 2001, Family medicine.

[6]  P. Leatt,et al.  IT solutions for patient safety--best practices for successful implementation in healthcare. , 2006, Healthcare quarterly.

[7]  F. Sullivan,et al.  A descriptive feast but an evaluative famine: systematic review of published articles on primary care computing during 1980-97 , 2001, BMJ : British Medical Journal.

[8]  David W. Bates,et al.  Position Paper: A Proposal for Electronic Medical Records in U.S. Primary Care , 2003, J. Am. Medical Informatics Assoc..

[9]  I. Sim,et al.  Physicians' use of electronic medical records: barriers and solutions. , 2004, Health affairs.

[10]  Jonathan M. Teich,et al.  The impact of computerized physician order entry on medication error prevention. , 1999, Journal of the American Medical Informatics Association : JAMIA.

[11]  Melanie Studer,et al.  The effect of organizational factors on the effectiveness of EMR system implementation--what have we learned? , 2005, Healthcare quarterly.

[12]  L. Spencer,et al.  Qualitative data analysis for applied policy research , 2002 .

[13]  J. Aaronson,et al.  Electronic medical records: the family practice resident perspective. , 2001, Family medicine.