What to expect from electronic patient record system implementation; lessons learned from published evidence

Background: Numerous studies have examined specific factors related to success, failure and implications of Electronic patient record (EPR) system implementations, but usually limited to specific aspects.  Objective: To review the published peer-reviewed literature and present findings regarding factors important in relation to successful EPR implementations and likely impact on subsequent clinical activity.Method: Literature reviewResults: 312 potential articles were identified on initial search of which 117 were relevant and included in the review. Several factors were related to implementation success, such as good leadership and management, infrastructure support, staff training and focus on workflows and usability. In general, EPR implementation is associated with improvements in documentation, and screening performance, and reduced prescribing errors, whereas there are minimal available data in other areas such as effects on clinical patient outcomes. The peer-reviewed literature appears to under-represent a range of technical factors important for EPR implementations, such as data migration from existing systems and impact of organisational readiness.Conclusion: The findings presented here represent synthesis of data from peer-reviewed literature in the field and should be of value to provide the evidence-base for organisations considering how best to implement an EPR system

Establishment of a small breeding colony of rhesus monkeys

A breeding colony of 22 female and 4 male rhesus monkeys (Maeaea mulatta) was established in a controlled-environment building with an outdoor run. The animals were quarantined for 2 years prior to their release into the unit. The housing, release and management of the colony are described. During the first year 19 young were born of which 17 have survived to 6 months of age. The cost of production and maintenance of the colony when compared with the cost of importing rhesus monkeys would appear to be acceptable. Traditionally, rhesus monkeys (Macaca mulatta) used in British research laboratories have been caught in their natural habitat and imported. Apart from welfare and husbandry considerations, wild-trapped rhesus monkeys have serious disadvantages as experimental animals: their origin, age and health status are uncertain, and they are liable to transmit severe or fatal infections to man. Recently, British import regulations have become more stringent, costs of importation have increased, and countries of origin have tended to restrict exports in order to conserve their natural stocks of monkeys. There is thus a generally increasing view that rhesus monkeys for research should be purpose bred (Hobbs & Bleby