Factors associated with difficult electronic health record implementation in office practice
- Marshall Fleurant1,
- Rachel Kell2,
- Chelsea Jenter3,
- Lynn A Volk4,
- Fang Zhang5,6,
- David W Bates3,4,7,8,
- Steven R Simon3,7,9
- 1Boston Medical Center, Boston, Massachusetts, USA
- 2Massachusetts eHealth Collaborative, Waltham, Massachusetts, USA
- 3Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- 4Partners HealthCare System, Inc., Wellesley, Massachusetts, USA
- 5Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- 6Department of Population Medicine, Boston, Massachusetts, USA
- 7Harvard Medical School, Boston, Massachusetts, USA
- 8Harvard School of Public Health, Boston, Massachusetts, USA
- 9Section of General Internal Medicine, VA Boston Healthcare System, Boston, Massachusetts, USA
- Correspondence to Dr Marshall Fleurant, Boston Medical Center, Boston University School of Medicine, Section of General Internal Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA; marshall.fleurant{at}bmc.org
- Received 6 November 2011
- Accepted 14 December 2011
- Published Online First 16 January 2012
Abstract
Little is known about physicians' perception of the ease or difficulty of implementing electronic health records (EHR). This study identified factors related to the perceived difficulty of implementing EHR. 163 physicians completed surveys before and after the implementation of EHR in an externally funded pilot program in three Massachusetts communities. Ordinal hierarchical logistic regression was used to identify baseline factors that correlated with physicians' report of difficulty with EHR implementation. Compared with physicians with ownership stake in their practices, physician employees were less likely to describe EHR implementation as difficult (adjusted OR 0.5, 95% CI 0.3 to 1.0). Physicians who perceived their staff to be innovative were also less likely to view EHR implementation as difficult (adjusted OR 0.4, 95% CI 0.2 to 0.8). Physicians who own their practice may need more external support for EHR implementation than those who do not. Innovative clinical support staff may ease the EHR implementation process and contribute to its success.
- Data exchange
- decision support
- electronic health records
- group practice
- health information technology
- implementation
- ownership
- patient safety
- practice management
- primary care
- quality of care
- veterans
Footnotes
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Funding This study was funded in part by the Agency for Healthcare Research and Quality cooperative agreement no 1UC1HS015397 and the Massachusetts e-Health Collaborative. MF was supported by a Ruth L. Kirschstein National Research Service Award grant no T32 HP12706.
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Competing interests None.
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Ethics approval The Partners HealthCare Human Research Committee approved the study protocol.
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Provenance and peer review Not commissioned; externally peer reviewed.
