OBJECTIVE
Examine how the Electronic Health Record (EHR) and its related systems support or inhibit provider collaboration.
BACKGROUND
Health care systems in the US are simultaneously implementing EHRs and transitioning to more collaborative delivery systems; this study examines the interaction between these two changes.
METHODS
This qualitative study of five US EHR implementations included 49 interviews and over 60 hours of provider observation. We examined the role of the EHR in building relationships, communicating, coordinating, and collaborative decision-making.
RESULTS
The EHR plays four roles in collaboration: a repository, a messenger, an orchestrator, and a monitor. While EHR performance varied, common themes were decreased trust due to poor quality documentation, incomplete communication, potential for increased effectiveness through better coordination, and the emerging role of the EHR in identifying performance gaps.
CONCLUSION
Both organizational and technical innovations are needed if the EHR is to truly support collaborative behaviors.