| Challenges to EHR implementation in electronic- versus paper-based office practices. | |
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MedLine Citation:
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PMID: 18369679 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Challenges in implementing electronic health records (EHRs) have received some attention, but less is known about the process of transitioning from legacy EHRs to newer systems. OBJECTIVE: To determine how ambulatory leaders differentiate implementation approaches between practices that are currently paper-based and those with a legacy EHR system (EHR-based). DESIGN: Qualitative study. PARTICIPANTS: Eleven practice managers and 12 medical directors all part of an academic ambulatory care network of a large teaching hospital in New York City in January to May of 2006. APPROACH: Qualitative approach comparing and contrasting perceived benefits and challenges in implementing an ambulatory EHR between practice leaders from paper- and EHR-based practices. Content analysis was performed using grounded theory and ATLAS.ti 5.0. RESULTS: We found that paper-based leaders prioritized the following: sufficient workstations and printers, a physician information technology (IT) champion at the practice, workflow education to ensure a successful transition to a paperless medical practice, and a high existing comfort level of practitioners and support staff with IT. In contrast, EHR-based leaders prioritized: improved technical training and ongoing technical support, sufficient protection of patient privacy, and open recognition of physician resistance, especially for those who were loyal to a legacy EHR. Unlike paper-based practices, EHR-based leadership believed that comfort level with IT and adjustments to workflow changes would not be difficult challenges to overcome. CONCLUSIONS: Leadership at paper- and EHR-based practices in 1 academic network has different priorities for implementing a new EHR. Ambulatory practices upgrading their legacy EHR have unique challenges. |
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Authors:
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Stephanie O Zandieh; Kahyun Yoon-Flannery; Gilad J Kuperman; Daniel J Langsam; Daniel Hyman; Rainu Kaushal |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-03-28 |
Journal Detail:
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Title: Journal of general internal medicine Volume: 23 ISSN: 1525-1497 ISO Abbreviation: J Gen Intern Med Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-19 Completed Date: 2008-07-21 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 8605834 Medline TA: J Gen Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 755-61 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA. stz2001@med.cornell.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ambulatory Care Facilities
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organization & administration* Attitude to Computers Hospitals, Teaching Humans Interviews as Topic Medical Records Systems, Computerized / organization & administration* New York City Organizational Innovation Physician Executives Practice Management, Medical / organization & administration* |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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