A conceptual framework for analyzing how Canadian physicians are using electronic medical records in clinical care.

Our electronic medical record (EMR) case study research pursued a set of questions to provide Canadian physicians with practical information on best practices and lessons learned regarding implementation and use of EMRs in ambulatory clinical care. The study's conceptual framework included an EMR System and Use Assessment Survey, interview guide, transcription codes, observation guide and case study report template. The common message that emerged was that no clinic would return to paper-based charts after experiencing the benefits of EMR. In seeking to corroborate our findings with success factors in an EMR implementation meta-framework, we further investigated the role of information incentives as a key factor in sustainable EMR implementations. The sections of our conceptual framework that best enabled us to capture information incentives were the 12 survey questions about information quality, EMR adoption questions in the interview guide and a subset of 26 items from our transcription coding scheme that were linked to physicians quotations about knowing more about the patient when using the EMR than when using paper.