Challenges to EHR Implementation in Electronic- Versus Paper-based Office Practices

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

doi:10.1007/s11606-008-0573-5

Cited by 102 publications

(67 citation statements)

References 13 publications

(17 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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“…Physician resistance has been cited as one of the greatest impediments to the implementation of computerized systems (Poon et al, 2004) and is perceived as one of the biggest challenges (Zandieh et al, 2008). As mentioned by Yarbrough and Smith (2007), physicians are often reluctant to use technologies that interrupt traditional practice processes.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Resistance to the information system (Deutscher et al, 2008;Zandieh et al, 2008) has been noted as being a detriment to the success of electronic health record implementations. All physicians using the system with few instances of resistance can indicate that the implementation will be fairly problem-free (Kleaveland, 2008).…”

Section: Literature Reviewmentioning

confidence: 99%

Electronic Health Records and User Participation: Digital Natives versus Digital Immigrants

House¹,

Mishra²

2015

IJBM

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The need for clarity in the healthcare management is a matter of frequent discussion and concern among healthcare professionals, practitioners, patients and academicians. Electronic Health Records would provide clarity, transparency, interoperability and transferability in the health care information and data of the patients. It will also reduce the human mistakes and will reduce the likelihood of wrongly reading or interpreting the information. This paper introduces this useful concept and links it to the two classes of health care practitioners-'digital natives' and 'digital immigrants'. The paper further identifies and discusses the relationship between user participation and system success and analyses the impact of moderation by digital natives and digital immigrants. The paper draws evidences from the existing state of literature to propose the relationships. Implications of the research to the practitioners and researchers are discussed.

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“…Strong support from senior management coupled with implementation leadership from key physicians is particularly vital. 2,5,7,9,[18][19][20] The VA Cardiovascular Assessment, Reporting, and Tracking System…”

Section: Background Health It Implementation In the United Statesmentioning

confidence: 99%

Strategies from a Nationwide Health Information Technology Implementation: The VA CART STORY

et al. 2010

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The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

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Challenges to EHR Implementation in Electronic- Versus Paper-based Office Practices

Cited by 102 publications

References 13 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

Electronic Health Records and User Participation: Digital Natives versus Digital Immigrants

Strategies from a Nationwide Health Information Technology Implementation: The VA CART STORY

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