This chapter introduces a multi-level, multidimensional meta-framework for successful implementations of EHR in healthcare organizations. Existing implementation frameworks do not explain many features experienced and reported by implementers and have not helped to make health information technology implementation any more successful. To close this gap, we have developed an EHR implementation f...

OBJECTIVE To evaluate the usability of concept mapping to elicit the expectations of healthcare professionals regarding the implementation of a new electronic health record (EHR). These expectations need to be taken into account during the implementation process to maximize the chance of success of the EHR. SETTING Two university hospitals in Amsterdam, The Netherlands, in the preparation pha...

It is widely believed that Electronic Health Records (EHR) improve medical decision-making by enabling medical staff to access medical information stored in the system. It remains unclear, however, whether EHR indeed fulfills this claim under the severe time constraints of Emergency Departments (EDs). We assessed whether accessing EHR in an ED actually improves decision-making by clinicians. A ...

BACKGROUND Electronic health records (EHR) are becoming increasingly integrated into the clinical environment. With the rapid proliferation of EHRs, a number of studies document an increase in adverse patient safety issues due to the EHR-user interface. Because of these issues, greater attention has been placed on novel educational activities which incorporate use of the EHR. The ICU environmen...

BACKGROUND The electronic health record (EHR) is increasingly viewed as a means to provide more coordinated, patient-centered care. Few studies consider the impact of EHRs on quality of care in the intensive care unit (ICU) setting. OBJECTIVES To evaluate key quality measures of a surgical intensive care unit (SICU) following implementation of the Epic EHR system in a tertiary hospital. MET...

OBJECTIVES This study sought to investigate user interactions with an electronic health records (EHR) system by uncovering hidden navigational patterns in the EHR usage data automatically recorded as clinicians navigated through the system's software user interface (UI) to perform different clinical tasks. DESIGN A homegrown EHR was adapted to allow real-time capture of comprehensive UI inter...

Although the electronic health record (EHR) is a promising innovation in the healthcare industry, the implementation of EHR has been relatively slow. A theoretical structure for the exploration and improvement of this usage of EHR is proposed. Incorporating the theoretical structure of TOE (technology-organization-environment), we apply the DEMATEL (decision-making trial and evaluation laborato...

The exchange of electronic health records (EHR) among multiple parties and for multiple purposes raises nontrivial concerns. Unfortunately, privacy and operational policies granting individual access privileges to parties are often artifacts foreign to healthcare systems, thus EHR security is all the more frail. Moreover, current web service technologies that constitute many EHR systems treat u...

As interest in the reuse of electronic health record (EHR) data for research purposes grows, so too does awareness of the significant data quality problems in these non-traditional datasets. In the past, however, little attention has been paid to whether poor data quality merely introduces noise into EHR-derived datasets, or if there is potential for the creation of spurious signals and bias. I...

D eciding whether to move to an electronic health record (EHR) system and which system to choose can be paralyzingly difficult questions. We hope this article can help. In the February 2005 issue of Family Practice Management, we published a survey instrument designed to elicit advice from family physicians already using EHR systems, and over the past several months we have collected more than ...