Leading change: introducing an electronic medical record system to a paramedic service

Abstract

(2016) Leading change: introducing an electronic medical record system to a paramedic service. Leadership in Health Services, 29 (2). pp. 136-150. The adoption use of EMR by in the emergency medical and ambulance setting is expected to provide across the health sector is a significant innovation providing wide-ranging benefits, but there is little research into processes of adoption in this sector. it remains little studied especially in the emergency medical and ambulance setting. This study examines the introduction of EMR in a small emergency care organization, and identifies factors that aided adoption. Design/methodology/approachSemi-structured interviews with selected paramedics were followed up with a survey issued to all paramedics in the company. FindingsThe user interface with the EMR, and perceived ease of use, were important factors affecting adoption. Additionally, Individual paramedics were found to have strong and varied preferences about how and when they integrated the EMR into their practice. As company leadership introduced multiple modes of access, resistance to the system decreased. Permitting flexibility of use, this enhanced both individual and collective ability to make sense of the significant technology change and removed barriers to acceptance. Research limitations/implicationsThis is a case study of one small organization. However, there may be useful lessons for other emergency care organizations adopting EMR. Practical implicationsPractical lessons are indicated for Leaders introducing EMR in similar situations may benefit from considering a sensemaking perspective, and responding promptly to feedback. Originality/valueThe study's findings were supportive of findings in a review of relevant, but limited, literature on the mandatory use of electronic medical records. By extending into a novel setting, that of paramedics out-of-hospital, The study contributes to a wider understanding of issues facing leaders those who seek to implement electronic

Electronic health records in ambulances: the ERA multiple-methods study

“…Studies examining implementation and adoption suggested that EMS agencies are adopting EHRs primarily for quality purposes, including quality assurance and quality improvement, as well as for billing purposes. 49,50,57 Other themes mentioned by one study each were workforce training needs analysis and education, 57 and reduced data loss and state mandates requiring services to adopt EHRs. 49 Barriers to EHR adoption included financial, organisational, technical and privacy/security reasons, fears of increasing run times, difficulty integrating EHRs with existing systems and difficultly in complying with legal mandates.…”

“…All participants in Baird and Boak's 50 research suggested that additional formal training may have aided earlier adoption, and the majority (79%) found informal learning from peers to be very helpful or somewhat helpful. Both Landman et al's 49 and Baird and Boak's 50 findings highlight the importance of support and training in aiding adoption.…”

“…All but one study were set in a single country, with one study sampling from the USA and Canada. 49 The majority of the studies (n = 10) were conducted in the USA, [50][51][52][53][54][55][56][57][58][59] two were conducted in Japan, 60,61 two in Australia 65,66 and one was conducted in each of Finland, 62 Italy 63 and the UK. 64 The identified literature is of limited quality.…”

“…The latter was the preferred method, used by 70% of staff; 20% used dictation and 10% called live operators. Baird and Boak 50 found that the introduction of optional additional hardware and software tools (e.g. keyboard and private laptop) aided adoption, with the majority of users (86%) finding the system easier to use with the addition of extra hardware tools.…”

“…Killeen et al 58 also found this to be the case, with participants of a full-scale disaster drill being able to readily adapt to and use EHR devices (PDAs/tablet computers) with little or no training on the device beforehand. However, Baird and Boak 50 found that more training could have aided adoption.…”