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International Journal of Telemedicine and Applications
Volume 2009 (2009), Article ID 853524, 9 pages
Research Article

Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

1Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Alberta, Canada T6G 2G8
2Sherwood Park - Strathcona County Primary Care Network, Sherwood Park, Alberta, Canada T8A 4W6
3TRLabs, #401, 9426, 51 Avenue NW, Edmonton, Alberta, Canada T6E 5A6

Received 29 April 2008; Revised 19 September 2008; Accepted 8 October 2008

Academic Editor: Hui Chen

Copyright © 2009 D. A. Ludwick and John Doucette. 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.


Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation.