Factors Affecting the Establishment of the Electronic Health Record in Family Physician Program: Providing a Model

Background & objectives: The Integrated Health System (SIB) is the latest electronic health record system in Iran, officially began in Iran in March 2016, with the goal of integrating health information and providing health services. This study aimed to design a model for establishment of the electronic health record in family physician program of Guilan university of medical sciences. Method: The research method was mixed method. Fifteen organizational and academic experts in the fields of family physician program and information technology were interviewed through purposive sampling using qualitative content analysis with conventional approach. Having identified the important components and respective dimensions in the initial conceptual model, the primary questionnaire was developed and submitted to the experts for their approval. Then, the final Likert-scale researcher-made questionnaire was extracted. Its content validity index was calculated by the experts and the reliability of the questionnaire was assessed through Cronbach’s alpha. The questionnaire was sent to 453 members of the healthcare team for being completed. Through analysing data by SPSS and LISREL, the final model was extracted using the specialized statistical techniques of exploratory and confirmatory factor analyses.  Results: The model was presented with eight factors of attitudinal and behavioural, supervision and managerial, individual factors of users, interactions and teamwork, organizational, technical, systemic and job stability which can explain over 63 percent of the variance of the variables of electronic health record-based family physician program. The highest and lowest impacts on the proposed model came from the managerial and supervisory (0.85) and the job stability components, respectively (0.45). Conclusion: Establishing an electronic health record in the family physician program with the aim of providing good quality services and lower costs, is influenced by various factors that by strengthening the positive aspects and removing barriers in the identified factors, it is possible to institutionalize and use it more practically in order to solve health problems.