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BMC Medicine
Published in: BMC Medicine 1/2011

Open Access 01-12-2011 | Research article

Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review

Authors: Carrie Anna McGinn, Sonya Grenier, Julie Duplantie, Nicola Shaw, Claude Sicotte, Luc Mathieu, Yvan Leduc, France Légaré, Marie-Pierre Gagnon

Published in: BMC Medicine | Issue 1/2011

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Abstract

Background

Electronic health record (EHR) implementation is currently underway in Canada, as in many other countries. These ambitious projects involve many stakeholders with unique perceptions of the implementation process. EHR users have an important role to play as they must integrate the EHR system into their work environments and use it in their everyday activities. Users hold valuable, first-hand knowledge of what can limit or contribute to the success of EHR implementation projects. A comprehensive synthesis of EHR users' perceptions is key to successful future implementation. This systematic literature review was aimed to synthesize current knowledge of the barriers and facilitators influencing shared EHR implementation among its various users.

Methods

Covering a period from 1999 to 2009, a literature search was conducted on nine electronic databases. Studies were included if they reported on users' perceived barriers and facilitators to shared EHR implementation, in healthcare settings comparable to Canada. Studies in all languages with an empirical study design were included. Quality and relevance of the studies were assessed. Four EHR user groups were targeted: physicians, other health care professionals, managers, and patients/public. Content analysis was performed independently by two authors using a validated extraction grid with pre-established categorization of barriers and facilitators for each group of EHR users.

Results

Of a total of 5,695 potentially relevant publications identified, 117 full text publications were obtained after screening titles and abstracts. After review of the full articles, 60 publications, corresponding to 52 studies, met the inclusion criteria. The most frequent adoption factors common to all user groups were design and technical concerns, ease of use, interoperability, privacy and security, costs, productivity, familiarity and ability with EHR, motivation to use EHR, patient and health professional interaction, and lack of time and workload. Each user group also identified factors specific to their professional and individual priorities.

Conclusions

This systematic review presents innovative research on the barriers and facilitators to EHR implementation. While important similarities between user groups are highlighted, differences between them demonstrate that each user group also has a unique perspective of the implementation process that should be taken into account.
Appendix
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Metadata
Title
Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review
Authors
Carrie Anna McGinn
Sonya Grenier
Julie Duplantie
Nicola Shaw
Claude Sicotte
Luc Mathieu
Yvan Leduc
France Légaré
Marie-Pierre Gagnon
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2011
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-9-46

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