Document Detail


Challenges to EHR implementation in electronic- versus paper-based office practices.
MedLine Citation:
PMID:  18369679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Stephanie O Zandieh; Kahyun Yoon-Flannery; Gilad J Kuperman; Daniel J Langsam; Daniel Hyman; Rainu Kaushal
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-28
Journal Detail:
Title:  Journal of general internal medicine     Volume:  23     ISSN:  1525-1497     ISO Abbreviation:  J Gen Intern Med     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-07-21     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8605834     Medline TA:  J Gen Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  755-61     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA. stz2001@med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care Facilities / 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*
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