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

<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

Gendered portrayals of mental health and mental illness in popular magazines in the United States

Research found that gendered stigma associated with mental health problems played an essential role in shaping public's perceptions about gender and mental illness. Magazines as a widely circulated printed media have long been understudied pertaining to the topic of mental health and mental health issues. This thesis explored the portrayals of mental health issues in four magazines (two men's magazines and two women's magazines) during a ten-year period from 2002-2011 through a content analysis. The current study examined the topics, cause and solution framing, sources cited, discourse type and message cues used in men's and women's magazines. Results indicated that magazines tended to cover general mental health terms such as stress or anxiety rather medically diagnosable illnesses such as depression. While these magazines were most likely to attribute mental illnesses to social causes, self-help was the solution most often proposed. Human interest discourse was more likely to be used than scientific discourse. Finally, magazines were more likely to use challenge code than stigma code in their coverage of mental illnesses. Men's magazines and women's magazines differed primarily from each other in the sources cited and discourse types. Women's magazines seemed to cite more frequently expert sources than men's magazines, especially academic sources. Moreover, women's magazines employed more scientific discourse than men's magazines. Limitations of this study were presented and future research directions were provided. (Published By University of Alabama Libraries