A qualitative analysis of an electronic health record (EHR)
implementation in an academic ambulatory setting

Yoon-Flannery, Kahyun; Zandieh, Stephanie O.; Kuperman, Gilad J.; Langsam, Daniel J.; Hyman, Daniel; Kaushal, Rainu

doi:10.14236/jhi.v16i4.703

Cited by 43 publications

(44 citation statements)

References 23 publications

(25 reference statements)

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“…We employed an extensive preimplementation planning process similar to that described by others. [25][26][27][28] This process included evaluation of several commercial EMR systems, hardware selection, and secure network installation to connect our practice sites. A medical director for informatics was named, and change champions were identified from multiple levels in our organization.…”

Section: Methodsmentioning

confidence: 99%

Patient Safety Perceptions of Primary Care Providers after Implementation of an Electronic Medical Record System

et al. 2012

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BACKGROUND: Increasing the use of electronic medical records (EMR) has been suggested as an important strategy for improving healthcare safety. OBJECTIVE: To sequentially measure, evaluate, and respond to safety culture and practice safety concerns following EMR implementation. DESIGN: Safety culture was assessed using a validated tool (Safety Attitudes Questionnaire; SAQ), immediately following EMR implementation (T1) and at 1.5 (T2) and 2.5 (T3) years post-implementation. The SAQ was supplemented with a practice-specific assessment tool to identify safety needs and barriers. PARTICIPANTS: A large medical group practice with a primary care core of 17-18 practices, staffed by clinicians in family medicine, pediatrics, internal medicine. INTERVENTIONS: Survey results were used to define and respond to areas of need between assessments with system changes and educational programs. MAIN MEASURES: Change in safety culture over time; perceived impact of EMR on practice. KEY RESULTS: Responses were received from 103 of 123 primary care providers in T1 (83.7 % response rate), 122 of 143 in T2 (85.3 %) and 142 of 181 in T3 (78.5 %). Safety culture improved over this period, with statistically significant improvement in all domains except for stress recognition. Time constraints, communications and patient adherence were perceived to be the most important safety issues. The majority of respondents in both T2 (77.9 %) and T3 (85.4 %) surveys agreed that the EMR improved their ability to provide care more safely. CONCLUSIONS: Implementation of an EMR in a large primary care practice required redesign of many organizational processes, and was associated with improvements in safety culture. Most primary care providers agreed that the EMR allowed them to provide care more safely.

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Section: Methodsmentioning

confidence: 99%

Patient Safety Perceptions of Primary Care Providers after Implementation of an Electronic Medical Record System

et al. 2012

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“…7 However, technological standards, better coordination across healthcare levels and incentives for physicians are still needed to facilitate EMR implementation in primary care. 8,9 Over the last few years, there have been some successful EMR implementations in specific regions of the Province of Québec. However, at the time of the present study, only one rural family medicine group (FMG) has implemented a full EMR system.…”

Section: Introductionmentioning

confidence: 99%

Implementation of an electronic medical record in family practice: a case study

Gagnon

Desmartis²,

Labrecque³

et al. 2010

Journal of Innovation in Health Informatics

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Background Electronic medical records (EMRs) have the potential to foster a safer, more effective and more efficient healthcare system. However, their implementation in primary care practice remains a challenge. Objective This study aims at exploring factors that have influenced the successful implementation of an EMR system in a family medicine group (FMG) in the Province of Québec, Canada. Methods A case study approach was selected to get a deep understanding of the phenomenon in its context. The case was chosen on the basis that it was the first FMG in Québec to implement a full EMR used by all clinicians. Fifteen semi-structured interviews were conducted with key informants. Results Factors that have influenced the success of the EMR implementation were classified under

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“…24 Early studies into EHRs uptake in public health agencies do not believe the benefits outweigh the deterrents of implementation and the EHRs themselves. These perceived deterrents of EHRs are costs of equipment and future maintenance, 25 lack of interoperability, 14 resistance to share data with other agencies, lack of skilled and trained staff, 21 and safety and quality issues. 26 Health departments may use EHRs for clinical case management, to contribute to HIEs, or may draw clinical information from HIEs or EHR systems directly for surveillance purposes.…”

Section: Electronic Health Recordsmentioning

confidence: 99%

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

Williams¹,

Shah²,

Leider³

et al. 2017

eGEMs

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Introduction: Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) are changing surveillance and analytic operations within local health departments (LHDs) across the United States. The objective of this study was to analyze the status, benefits, barriers, and ways of overcoming challenges in the implementation of EHRs and HIEs in LHDs. Methods:This study employed a mixed methods approach, first using the 2013 National Profile of LHDs survey to ascertain the status of EHR and HIE implementation across the US, as well as to aid in selection of respondents for the second, interview-based part of project. Next, forty-nine key-informant interviews of local health department staff were conducted. Data were coded thematically and independently by two researchers. Coding was compared and re-coded using the consensus definitions.Results: Twenty-three percent of LHDs nationwide are using EHRs and 14 percent are using HIEs. The most frequently mentioned benefits for implementation were identified as care coordination, retrieval or managing information, and the ability to track outcomes of care. A few mentioned barriers included financial resources, resistance to change, and IT related issues during implementation.Discussion: Despite financial, technical capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Recent policy changes and accreditation have implications of improving processes to affect populations served. Conclusions:Overcoming the challenges in implementing EHRs can result in increased efficiencies in surveillance and higher quality patient care and tracking. However, significant opportunity cost does exist.

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A qualitative analysis of an electronic health record (EHR) implementation in an academic ambulatory setting

Cited by 43 publications

References 23 publications

Patient Safety Perceptions of Primary Care Providers after Implementation of an Electronic Medical Record System

Patient Safety Perceptions of Primary Care Providers after Implementation of an Electronic Medical Record System

Implementation of an electronic medical record in family practice: a case study

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

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