What to expect from electronic patient record system implementation: lessons learned from published evidence

Abstract

BackgroundNumerous studies have examined factors related to success, failure and implications of electronic patient record (EPR) system implementations, but usually limited to specific aspects.ObjectiveTo review the published peer-reviewed literature and present findings regarding factors important in relation to successful EPR implementations and likely impact on subsequent clinical activity.MethodLiterature review.ResultsThree hundred and twelve potential articles were identified on initial search, of which 117 were relevant and included in the review. Several factors were related to implementation success, such as good leadership and management, infrastructure support, staff training and focus on workflows and usability. In general, EPR implementation is associated with improvements in documentation and screening performance and reduced prescribing errors, whereas there are minimal available data in other areas such as effects on clinical patient outcomes. The peer-reviewed literature appears to under-represent a range of technical factors important for EPR implementations, such as data migration from existing systems and impact of organisational readiness.ConclusionThe findings presented here represent the synthesis of data from peer-reviewed literature in the field and should be of value to provide the evidence-base for organisations considering how best to implement an EPR system.

Lessons learned from a comprehensive electronic patient record procurement process—implications for healthcare organisations

“…Development of a stakeholder map of key staff groups prior to commencement of the procurement process, along with securing protected time for these staff to be actively involved throughout resulted in excellent levels of clinical engagement with the process (>200 clinical and operational staff from across all areas of the hospital were involved to avoid EPR being envisaged as an ‘IT’ project). Poor staff inclusion has been previously reported as a factor associated with unsuccessful implementations 1…”

“…At the outset of the process we intended to use learnings from published evidence, but while numerous peer-reviewed papers regarding healthcare implementation were available,1 there was a paucity of practically useful publications regarding details of the process and learnings from other centres regarding EPR systems. The use of clinical scenario simulation and evaluation for usability has been described,2 as have the use of usability questionnaires,3 but no information was available regarding practical lessons from other centres, such as which elements of the evaluation process were most discriminatory and whether there were specific issues detected during the procurement process which would have been useful to have been aware of initially.…”

Sairaanhoitajien valmiudet tiedonhallintaan sekä kokemukset potilas- ja asiakastietojärjestelmien tuesta työtehtäviin

“…Vaikutukset käyttöönotosta saadaan esiin usein vuosien viiveellä [16,21]. Tutkimustulokset osoittavat tietojärjestelmien käytön olevan yhteydessä kirjaamisen laadun paranemiseen ja lääkemääräysvirheiden vähenemiseen, mutta näyttöä vaikutuksista hoidon tuloksiin on vähän [5,12,[22][23][24].…”

The Rise of EPR in The UK: A Cross-Sectional Study Examining The Effect of The Transition to EPR on Adherence to VTE Prophylaxis Guidelines in General Surgical Patients

“…The Care Quality Commission inspection only found signi cant improvements in their record keeping two years after the implementation of EPR. Therefore, it is possible that the TED prescription rates fell due to a 'productivity dip' [14] phase after the EPR system was implemented. This is possibly due to staff being unfamiliar with the system or technological glitches in the software, etc.…”