The gap between actual and mandated use of an electronic medication record three years after deployment.

Three years after the hospitals in one of Denmark's five healthcare regions deployed an electronic medication record (EMR) four of eight main system facilities are used consistently by only 3%-37% of the hospital wards. Furthermore, four of eight mandated work procedures involving the EMR are followed consistently by only 13%-28% of wards. No system facility or work procedure is consistently adopted by more than 67%, respectively 48%, of wards. Barriers to adoption of the EMR include system factors, such as the EMR being perceived as prohibitively time consuming to use, as well as human factors, such as lack of knowledge, information, and training among clinicians. However, the prime barrier appears to be uncertainty about what the barriers concretely are and about the extent to which system facilities and work procedures are actually adopted. Three years after deployment it is apparent that time alone does not lead to consistent adoption. Rather, interventions are necessary to overcome the barriers.