Int J Med Inform. ... An initial exploratory scope of the EHR literature in the PubMed database was reviewed by the expert panel and the final research question, methodology and search strategy were developed and agreed. Nevertheless the results of these IT-based innovations do not meet the expected improvements in healthcare performance. Participation of employees is perceived to increase their acceptation of, the IT system. We also thank the referees for their valuable comments. The Newcastle-Ottawa scale was used to assess study quality. This also requires adequate hardware, in terms of access to computers, and mobile equipment to, enable availability at all the locations of the hospital. In recent years, Electronic Health Records (EHRs) have been implemented by an ever increasing number of hospitals around the world. The importance of. identify generally applicable findings and lessons for implementers. Springer Nature. Thus, there is ample evidence of the crucial importance of physicians’ acceptance of an EHR for it to be implemented. These studies recognize that EHR implementation is relatively unpredictable due to unforeseen contingencies for which one cannot plan. of a computerized physician order entry system in a large dutch, implementation of computerized physician order entry in two Dutch. Variables considered are time, change approach, and change management. From the case studies it can be concluded that the relevance of EHR merely focuses on the availability of information at any time and any place. Finding A2 is a reminder of the importance of, carefully selecting an appropriate vendor, taking into ac, count experience with the EHR market and the maturity of. As Grimson et al. The second theme identified, coined CBI, includes factors associated with hindering EHR implementation. Impact Organ Culture Behav Acad Med. Descriptive statistics were used to summarise effect estimates. [11] and McGinn et al. Join ResearchGate to find the people and research you need to help your work. Simon SR, Keohane CA, Amato M, Coffey M, Cadet M, Zimlichman E: Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. define a CPOE, common features of automating the medication order, the literature were not included in this review as they, In order for a systematic literature review to be compre, hensive, it is essential that all terms relevant, of the research are covered in the search. Background: They anticipated the need for education and training of a wide range of users (preparation). our knowledge of the diffusion and transmission of the Circa instans in England and to the history of medicine in the Middle Ages. The used participation approaches do not facilitate diffusion of EHR in hospitals. used included Web of Knowledge, EBSCO, and Cochrane Library. Second, as, with the other two original categories of terms, and the, CPOE. The FITT-framework of Ammenwerth was used to guide the interview topic list and to formulate themes to explore. The earlier introduced, understanding strategic change, includes three cat-, egories: context (A), content (B), and process (C). ... On the other hand 5 (5.05%) patient administrators also indicated that they were not sure. BMC Health Services Research At the same time the software, prove its processes. Third, the implementation of a comprehensive electronic medical record requires physicians to make direct order entries [19]. [17] view both terms as having the same meaning and referring to a system that contains clinical information from a particular hospital. This framework can function as a reference for implementers in developing effective EHR implementation strategies for hospitals. This study aimed to compare the importance of the main barriers from the experts’ point of views in Iran. Keshavjee K, Bosomworth J, Copen J, Lai J, Kucukyazici B, Liani R, Holbrook AM: Best practices in EMR implementation: a systematic review. A crucial condition for the acceptance by the diverse user groups of hospitals is the robustness of the EHR system in terms of availability, speed, reliability and flexibility (B2). When removing duplicates, we retained the link to the first search engine that identified the article and, as the Web of Knowledge was the first search engine used, most articles appear to have stemmed from this search engine. Health information technology (HIT) is known to reduce prescribing errors but may also cause new types of technology-generated errors (TGE) related to data entry, duplicate prescribing, and prescriber alert fatigue. Although this term is not mentioned by ISO [16] or by Häyrinen et al. The framework with its three, In the literature, several terms are used to refer to. 1987, 24 (6): 649-670. The articles identified from the various search strategies had to be academic peer-reviewed articles if they were to be included in our review. [32] propose that this involvement should have an extensive timeframe, starting in the early stages of implementation, when initial vendor requirements are formulated (‘consultation before implementation’), through to the beginning of the use phase. Two, interesting related review studies on EHR implementa-. Selection should be based on a careful requirements analysis and an analysis of the experience and quality of the vendor. of How Clinical Information System Implementation Affects Workflow. This reflects the recent increase in effort to implement organization-wide information systems, such as EHR systems, and also increasing incentives from governments to make use of EHR systems in hospitals. Katsma et al. Both studies, are not explicitly focused on hospitals and include other, contexts such as small clinics and national or regional, that reflect this situation. The categorization of the findings from the selected articles draws on Pettigrew’s framework for understanding strategic change [13]. Not, surprisingly, many duplicates were included in the 364, articles, both within and between search engines. a rating of 2 (completely addressed), 1 (partly addressed), of the scores of the articles, (per question) for qualitative, mixed methods studies. The former apparently perceive the costs of EHR im-, plementation to outweigh the benefits. Inform Prim Care. The findings regarding the content of the EHR system (Category B) highlight the importance of a suitable software product. The quality of the articles was assessed with the Standard, Quality Assessment Criteria for Evaluating Primary Re-, search Papers [18]. Both studies are not explicitly focused on hospitals and include other contexts such as small clinics and national or regional EHR initiatives. This review of the existing academic literature sheds light on the current knowledge regarding EHR implementation. It is clear that EHR systems, have particular complexities and should be implemented, with great care, and with attention given to context, con-, tent, and process issues and to interactions between these, issues. order entry in the field: lessons learned in a multi-center study. cles appear to have stemmed from this search engine. One of the assertions is that privately owned hospitals are less likely than public hospitals to invest in an EHR. Connection to a theoretical framework/wider body of knowledge? Work: Implications for the Electronic Medical Record. Electronic Health Records Electronic Health Record (EHR) Implementation Ease the transition from paper to electronic health records. This qualitative study was based on semi-structured interviews with 115 health care professionals: 16 psychiatrists, 84 nurses, six psychologists or social assistants and nine secretaries or administrative professionals. Subject (and comparison group, if applicable) characteristics sufficiently described? Aim The privacy construct shows a negative effect on EMR acceptance and use. Sufficient human resources include the selection, of competent and experienced project leaders who are, familiar with EHR implementation. into a mental health hospital in England. Similarly, internal findings related to aspects such as perceived financial benefits or improved quality of care, are outside our scope. Lessons learned from implementation of computerized provider order. Teaching and non-teaching hospitals are almost equally the subject of inquiry, and some researchers have focused on specific types of hospitals such as rural, critical access, or psychiatric hospitals. This framework was specifically selected for its focus on organizational change, its ease of understanding, and its relatively general dimensions allowing a broad range of findings to be included. Two interesting related review studies on EHR implementation are Keshavjee et al. Br Med J. assets necessary to renew its organizational capabilities (knowledge exploitation). 2009, 360: 1628-1638. This article discusses and presents an edition of a Middle English pharmacopoeia based on the Latin Circa instans, which is found in Glasgow, University Library, MS Hunter 307 (U.7.1), fols. The researcher conducted a narrative literature review to identify breadth of knowledge currently available surrounding EHR implementation and change management. To ensure EHR implementation, the software needs to be user-friendly with regard to. As such, the objective of this research is to identify, categorize, and analyze the existing findings in the literature on EHR implementation processes in hospitals. Aarts and Berg [22] introduce a model of success or failure in information system implementation. frameworks, if present, are outlined in Table 3. [8,18]. The literature is diffuse, and articles seldom build on earlier ones to increase the theoretical knowledge on EHR implementation, notable exceptions being Aarts et al., 2011. 2007, 8 (6): 625-643. Rivard et al. Analysis of observations and interviews resulted in findings about the CPOE implementation process in five domains: governance, preparation, support, perceptions and consequences. Little is known of the facilitators and barriers of capturing the required data for emergency department key performance indicators. Methods As Grimson et al. By categorizing the findings in terms of subject, and by totaling the number of articles related to the individual findings on that subject, one can deduce how much attention has been given in the literature to the different topics. Hospital management and nurse leadership should be aware and informed about the importance of the fit between technology, task and individual regarding adequate adoption of HIT. Academic Medicine 68(1993):20-25. First, it is considered by many to be a key hospital-wide function of an EHR system e.g. Aarts and Berg [22] introduce a model, of success or failure in information system implementa-, tion. 2011, 29 (9): 502-511. Abramson EL, McGinnis S, Edwards A, Maniccia DM, Moore J, Kaushal R: Electronic health record adoption and health information exchange among hospitals in New York State. Nurses who are digitally lagging behind often have had insufficient and ineffective digital education. 1994, 653: 7. Am J Manage Care. adapt POE at the local level, creating acceptance among physicians. The active in-, tion of clinical staff (C2), a comprehensive implementation, support a strong leader role; (2) communicate, involve, people, and be honest; and (3) craft an implementation, plan. Article  Clinical staff should participate at all, levels and in all steps [19,28,32,36] from initial system, selection onwards [35]. B1: Creating a fit by adapting both the technology and, work practices is a key factor in the implementation of EHR, This finding elaborates on the sociotechnic, identified in the earlier section on the theories adopted, in the articles. However, HIT implementations in hospitals are not yet commonly guided by theory [78. All authors have read and approved the final manuscript. Most search engines use several databases but not all of them were relevant for this research as they serve a wide range of fields. Results: The global theme “Understanding facilitators and barriers for emergency department data collection systems” emerged from three organizing themes: “understanding current emergency department data collection systems”; “achieving the ideal emergency department data capture system for the implementation of emergency department key performance indicators”; and “emergency department data capture systems for performance monitoring purposes within the wider context”. The governance of the EHR implementation [13,19,37], as well as leaders [7,10,36,44,48,[52][53][54]62,63] and organizational culture, were identified as paramount in ensuring a successful EHR system [7,10,13. EHR systems can be used in individ-. it “sticks”) when the implementation carefully considers and aligns the e-Health content (the “clicks”), the pre-existing structures in the context (the “bricks”), and the interventions in the implementation process (the “tricks”). Lundberg S, Bergman M: Tender evaluation and supplier selection methods in public procurement. Here are ten essential steps to take for a successful EHR Implementation. 10.1136/bmj.38638.497477.68. Introduction:The process of design and adoption of electronic health records may face a number of barriers. Mangalmurti SS, Murtagh L, Mello MM (2010) Medical malpractice liability in the age of electronic health records. Article  consisting of developers, members of the IT department, and end-users fosters EHR implementation success, C6: Resistance of clinical staff, in particular of physicians, is, a major barrier to EHR implementation, but can be reduced, mentation [36]. Of these resulting 24 articles, two proved to be almost identical so one was excluded, resulting in 23 articles for a final quality assessment.The results of the quality assessment can be found in Appendix B. Boonstra, A., Versluis, A. 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