Secondary Users Interpretations On Key Concerns For Achieving An Effective And Efficient Region-Wide Electronic Patient Record Usage

The paper presents secondary users’ interpretation of key concerns (KCs) for achieving an efficient and effective electronic patient record (EPR) usage. The study is based on twelve interviews with Clinical Directors and IT Directors that are responsible for delivering high quality care, procuring and implementing IT. The participants represented five Swedish county councils who all use a region-wide EPR for primary care and hospital services. The analysis indicated that there was an unresolved conflict regarding what influence the IT should have on the health professionals’ practice. Either the systems’ usability or the health professionals’ unwillingness to change was blamed for the problems. We argue that most of this conflict is the idea that one EPR is going to support all user groups and that using a region-wide EPR is not necessarily the problem. In the studied organisations, however, it became a problem because to achieve “one system that fits all” the fact that different user groups had different needs, roles and responsibilities was neglected. Neglecting the users’ needs will not solve the problems but will instead increase the conflict. Using the KC will shed light on differences between primary and secondary users interpretations of the aim of the region-wide EPR.