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BioMed Research International
Volume 2013 (2013), Article ID 629574, 9 pages
Research Article

Facilitating Ambulatory Electronic Health Record System Implementation: Evidence from a Qualitative Study

1Department of Family Medicine, College of Medicine, The Ohio State University, 273 Northwood and High Building, 2231 North High Street, Columbus, OH 43201, USA
2Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 250 Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, USA
3Department of Biomedical Informatics, College of Medicine, The Ohio State University, 3190 Graves Hall, 333 W. 10th Avenue, Columbus, OH 43210, USA

Received 1 May 2013; Accepted 2 September 2013

Academic Editor: Gudlavalleti Venkata Murthy

Copyright © 2013 Ann Scheck McAlearney et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Ambulatory care practices have increasing interest in leveraging the capabilities of electronic health record (EHR) systems, but little information is available documenting how organizations have successfully implemented these systems. Objective. To characterize elements of successful electronic health record (EHR) system implementation and to synthesize the key informants' perspectives about successful implementation practices. Methods. Key informant interviews and focus groups were conducted with a purposive sample of individuals from US healthcare organizations identified for their success with ambulatory EHR implementation. Rigorous qualitative data analyses used both deductive and inductive methods. Results. Participants identified personal and system-related barriers, at both the individual and organization levels, including poor computer skills, productivity losses, resistance to change, and EHR system failure. Implementation success was reportedly facilitated by careful planning and consistent communication throughout distinct stages of the implementation process. A significant element of successful implementation was an emphasis on optimization, both during “go-live” and, subsequently, when users had more experience with the system. Conclusion. Successful EHR implementation requires both detailed planning and clear mechanisms to deal with unforeseen or unintended consequences. Focusing on user buy-in early and including plans for optimization can facilitate greater success.