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Implementation Science
Published in: Implementation Science 1/2014

Open Access 01-12-2014 | Research

The preferences of users of electronic medical records in hospitals: quantifying the relative importance of barriers and facilitators of an innovation

Authors: Marjolijn HL Struik, Ferry Koster, A Jantine Schuit, Rutger Nugteren, Jorien Veldwijk, Mattijs S Lambooij

Published in: Implementation Science | Issue 1/2014

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Abstract

Background

Currently electronic medical records (EMRs) are implemented in hospitals, because of expected benefits for quality and safety of care. However the implementation processes are not unproblematic and are slower than needed. Many of the barriers and facilitators of the adoption of EMRs are identified, but the relative importance of these factors is still undetermined. This paper quantifies the relative importance of known barriers and facilitators of EMR, experienced by the users (i.e., nurses and physicians in hospitals).

Methods

A discrete choice experiment (DCE) was conducted among physicians and nurses. Participants answered ten choice sets containing two scenarios. Each scenario included attributes that were based on previously identified barriers in the literature: data entry hardware, technical support, attitude head of department, performance feedback, flexibility of interface, and decision support. Mixed Multinomial Logit analysis was used to determine the relative importance of the attributes.

Results

Data on 148 nurses and 150 physicians showed that high flexibility of the interface was the factor with highest relative importance in their preference to use an EMR. For nurses this attribute was followed by support from the head of department, presence of performance feedback from the EMR and presence of decisions support. While for physicians this ordering was different: presence of decision support was relatively more important than performance feedback and support from the head of department.

Conclusion

Considering the prominent wish of all the intended users for a flexible interface, currently used EMRs only partially comply with the needs of the users, indicating the need for closer incorporation of user needs during development stages of EMRs. The differences in priorities amongst nurses and physicians show that different users have different needs during the implementation of innovations. Hospital management may use this information to design implementation trajectories to fit the needs of various user groups.
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Metadata
Title
The preferences of users of electronic medical records in hospitals: quantifying the relative importance of barriers and facilitators of an innovation
Authors
Marjolijn HL Struik
Ferry Koster
A Jantine Schuit
Rutger Nugteren
Jorien Veldwijk
Mattijs S Lambooij
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2014
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-9-69

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