Assessing the process of designing and implementing electronic health records in a statewide public health system: the case of Colima, Mexico

Abstract

The findings of a case study assessing the design and implementation of an electronic health record (EHR) in the public health system of Colima, Mexico, its perceived benefits and limitations, and recommendations for improving the implementation process are presented. In-depth interviews and focus group discussions were used to examine the experience of the actors and stakeholders participating in the design and implementation of EHRs. Results indicate that the main driving force behind the use of EHRs was to improve reporting to the two of the main government health and social development programs. Significant challenges to the success of the EHR include resistance by physicians to use the ICD-10 to code diagnoses, insufficient attention to recurrent resources needed to maintain the system, and pressure from federal programs to establish parallel information systems. Operating funds and more importantly political commitment are required to ensure sustainability of the EHRs in Colimaima.

A Review of Health Information Technology Implementation Success Factors: Importance of Regulation and Finance

“…Such as finances and staff [7], [14], [25], [30] 4 11.11% Commitment and support from executives leaders [8], [11], [25], [29] 4 11.11%…”

“…finance and staff) are important to ensure sustainability of HIT projects [14], [25], [30]. The source of such finances is often from the healthcare organization and/or the government, but researchers point out that alternative sources of finances -such as insurance companies and the patients themselves -for HIT need to be considered as well [7].…”

“…state officials) is necessary [17], [25], [30], [32]. For example, [18] stated that IT staff should collaborate with nurse and physician leaders in planning process redesign.…”

“…The actions of the national and local government thus have direct bearing on the success of individual HIT implementations in healthcare organizations through these instruments [30].…”

“…regulatory and financial framework) is particularly important in healthcare because healthcare in general and HIT in particular is often heavily regulated and financed by the government. The sustainability of many HIT projects is threatened when grants or financial support from the government are suspended [30], [46]. Other aspects of external environment such as standardized data contents or legal requirements which govern healthcare services as well as HIT applications can also have influences on the outcome of HIT implementation [47].…”