104 research outputs found

    Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review

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    <p>Abstract</p> <p>Background</p> <p>Electronic health record (EHR) implementation is currently underway in Canada, as in many other countries. These ambitious projects involve many stakeholders with unique perceptions of the implementation process. EHR users have an important role to play as they must integrate the EHR system into their work environments and use it in their everyday activities. Users hold valuable, first-hand knowledge of what can limit or contribute to the success of EHR implementation projects. A comprehensive synthesis of EHR users' perceptions is key to successful future implementation. This systematic literature review was aimed to synthesize current knowledge of the barriers and facilitators influencing shared EHR implementation among its various users.</p> <p>Methods</p> <p>Covering a period from 1999 to 2009, a literature search was conducted on nine electronic databases. Studies were included if they reported on users' perceived barriers and facilitators to shared EHR implementation, in healthcare settings comparable to Canada. Studies in all languages with an empirical study design were included. Quality and relevance of the studies were assessed. Four EHR user groups were targeted: physicians, other health care professionals, managers, and patients/public. Content analysis was performed independently by two authors using a validated extraction grid with pre-established categorization of barriers and facilitators for each group of EHR users.</p> <p>Results</p> <p>Of a total of 5,695 potentially relevant publications identified, 117 full text publications were obtained after screening titles and abstracts. After review of the full articles, 60 publications, corresponding to 52 studies, met the inclusion criteria. The most frequent adoption factors common to all user groups were design and technical concerns, ease of use, interoperability, privacy and security, costs, productivity, familiarity and ability with EHR, motivation to use EHR, patient and health professional interaction, and lack of time and workload. Each user group also identified factors specific to their professional and individual priorities.</p> <p>Conclusions</p> <p>This systematic review presents innovative research on the barriers and facilitators to EHR implementation. While important similarities between user groups are highlighted, differences between them demonstrate that each user group also has a unique perspective of the implementation process that should be taken into account.</p

    Applying sense-making to integrated health IT: Renal care in the UK and Sweden

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    Information technology (IT) in healthcare combines opportunities for improved integrated healthcare delivery with barrierswhich include clinician resistance and low adoption rates. While national level initiatives are taken to promote electronichealthcare (e-health), it is at the grassroots level that their outcomes unfold. This paper employs sense-making theory toextend prior research on the implementation of health IT by investigating the introduction of IT into renal care units in theUK and Sweden. Issues such as management support, user training, usability of systems and perceived benefits of technologywere found to have a direct impact on users’ sense-making processes. The manner in which people make sense of imposedsystems has far reaching effects, as the gap between intended results and actual outcomes is not limited to disparities betweenmicro-level end-users alone, but spans multiple levels including higher authorities, as well as individuals at the grassrootslevel

    Factors Associated with EHR User Satisfaction in Small Clinic Settings

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    The research on electronic health record (EHR) user satisfaction has been mainly studied in a complex work environment such as hospitals. Little is known about the EHR user satisfaction in small clinic settings. In this study, we investigate factors associated with EHR user satisfaction is small clinic settings. We use the absorptive capacity lens at an end-user level to understand how small clinics can effectively implement EHR systems and improve user satisfaction. We identify three important factors that are critical for EHR user satisfaction in small clinics – (i) Managerial IT knowledge as manifested in clinical management support, (ii) technological training (informal and formal) as indicated by EHR training, and (iii) IT infrastructure capability operationalized as EHR quality. We propose a research model and associated hypotheses for our research and present current status of our research project

    An Exploratory Study on Physicians\u27 Diligence when Dealing with Patient Data

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    Recent history shows an increasing number of privacy breaches, usually attributed to a lack of diligence when handling personal data. Little awareness for privacy concerns is asserted as the pivotal negative effect on diligence. Challenging this conventional wisdom, this study shows that physicians are fully aware of the privacy issues. Their lack of diligence mainly results from a trade-off between the prospected consequences resulting from a privacy breach and the impediments diligent data handling has on the actual workflow of the physicians. Based on the grounded theory method, we chose hospitals as research field since patient data is commonly perceived as especially sensitive. We add to the body of knowledge by emphasizing the role of actors processing personal data in contrast to existing research that focuses on the behavior of affected actors, such as consumers. In sum, we provide a new perspective on the factors leading to privacy breaches

    Technical requirements framework of hospital information systems: Design and evaluation

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    Background: Implementing the health information system (HIS) is more complex and costly than implementing other information systems. The present study was conducted to design and evaluate technical requirements for the HIS. Methods: The present study was conducted in 2016 by determining technical requirements for the HIS using the Delphi technique and then evaluating this system using a checklist based on the approved requirements. Results: The first part of the study designed a 73-item final list of technical requirements for the HIS in four domains, i.e. communication service, system architecture, security service and system response time. The evaluation results obtained in the second part showed that communication service was met in 63.8 of the HIS programs, system architecture in 65.5, security service in 72.4 and system response time in 76.3. Conclusions: A technical evaluation tool was designed and used to select and evaluate the HIS. The evaluation results suggested the study HIS was poorer in terms of communication service and system architecture than in the other two dimensions. © 2020 The Author(s)

    INVESTIGATING THE NON-ADOPTION OF ELECTRONIC HEALTH RECORDS IN PRIMARY CARE

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    The objective of this study was to investigate the underlying reasons behind primary care centers in the United States not implementing an Electronic Health Record system in spite of looming penalties under the Health Information Technology for Economic and Clinical Health (HITECH) Act. In order to do this, survey was developed and distributed among healthcare providers who have not yet implemented an EHR system at their practice. The questions for the survey were developed after conducting a literature review of the barriers to EHR implementation. In this review, six themes emerged: technical, cost, productivity, change process, privacy and time. These 6 categories served as the foundation for the survey which consisted of 30 questions. The results from the survey were analyzed using SPSS. From the analysis we see what the participants perceive as the most significant of barriers and also see that nurses and doctors are divided in their opinion of the EHRs, where the former perceive them as them as not being useful and the latter seem to think otherwise. Further research may be conducted on determining why this is so

    eHealth adoption and use among healthcare professionals in a tertiary hospital in Sub-Saharan Africa: a Qmethodology study

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    Copyright 2019 Ladan et al. Background. The aim of the study was to explore the viewpoints of healthcare professionals (HCPs) on the adoption and use of eHealth in clinical practice in sub-Saharan Africa (SSA). Information and communication technologies (ICTs) including eHealth provide HCPs the opportunity to provide quality healthcare to their patients while also improving their own clinical practices. Despite this, previous research has identified these technologies have their associated challenges when adopting them for clinical practice. But more research is needed to identify how these eHealth resources influence clinical practice. In addition, there is still little information about adoption and use of these technologies by HCPs inclinical practice in Sub-Saharan Africa. Method. An exploratory descriptive design was adopted for this study. Thirty-six (36) HCPs (18 nurses and 18 physicians) working in the clinical area in a tertiary health institution in SSA participated in this study. Using Qmethodology, study participants rank-ordered forty-six statementsin relation to their adoption and use of eHealth within their clinical practice.This was analysed using by-person factor analysis and complemented with audio-taped interviews. Results. The analysis yielded four factors i.e., distinct viewpoints the HCPs hold about adoption and use of eHealth within their clinical practice. These factors include: Patient-focused eHealth advocates" who use the eHealth because they are motivated by patients and their families preferences; Task-focused eHealth advocates" use eHealth because it helps them complete clinical tasks; Traditionalistic-pragmatists" recognise contributions eHealth makes in clinical practice but separate from their routine clinical activities; and the Tech-focused eHealth advocates" who use the eHealth because they are motivated by the technology itself. Conclusion. The study shows the equivocal viewpoints that HCPs have about eHealth within their clinical practice. This, in addition to adding to existing literature, will help policymakers/decision makers to consider HCPs views about these technologies prior to implementing an eHealth resource
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