OBJECTIVE: To apply the diffusion-of-innovations theory to the examination of factors that are perceived by family physicians as influencing the implementation of electronic medical records (EMRs). DESIGN: Qualitative study with 2 focus groups 18 months after EMR implementation; participants also took part in a concurrent quantitative study examining EMR implementation and preventive services. SETTING: Toronto, Ont. PARTICIPANTS: Twelve community-based family physicians. METHODS: We employed a semistructured interview guide. The interviews were audiotaped and transcribed verbatim; 2 researchers independently categorized and coded the transcripts and then met to compare and contrast their findings, category mapping, and interpretations. Findings were then mapped to an existing theoretical framework. MAIN FINDINGS: Multiple barriers to EMR implementation were described. These included lack of relative advantage for many processes, high complexity of the system, low compatibility with physician needs and past experiences, difficulty with adaptation of the EMR to the organization and adaptation of the organization to the EMR, and lack of organizational slack. Positive factors were the presence of a champion and relative advantages for some processes. CONCLUSION: Early EMR implementation experience is consistent with theoretical concepts associated with implementation of innovations. A problematic implementation process helps to explain, at least in part, the lack of improvement in preventive services in our quantitative results.
OBJECTIVE: To apply the diffusion-of-innovations theory to the examination of factors that are perceived by family physicians as influencing the implementation of electronic medical records (EMRs). DESIGN: Qualitative study with 2 focus groups 18 months after EMR implementation; participants also took part in a concurrent quantitative study examining EMR implementation and preventive services. SETTING: Toronto, Ont. PARTICIPANTS: Twelve community-based family physicians. METHODS: We employed a semistructured interview guide. The interviews were audiotaped and transcribed verbatim; 2 researchers independently categorized and coded the transcripts and then met to compare and contrast their findings, category mapping, and interpretations. Findings were then mapped to an existing theoretical framework. MAIN FINDINGS: Multiple barriers to EMR implementation were described. These included lack of relative advantage for many processes, high complexity of the system, low compatibility with physician needs and past experiences, difficulty with adaptation of the EMR to the organization and adaptation of the organization to the EMR, and lack of organizational slack. Positive factors were the presence of a champion and relative advantages for some processes. CONCLUSION: Early EMR implementation experience is consistent with theoretical concepts associated with implementation of innovations. A problematic implementation process helps to explain, at least in part, the lack of improvement in preventive services in our quantitative results.
Authors: Michelle Greiver; Jan Barnsley; Richard H Glazier; Rahim Moineddin; Bart J Harvey Journal: Can Fam Physician Date: 2011-10 Impact factor: 3.275
Authors: Li Zhou; Christine S Soran; Chelsea A Jenter; Lynn A Volk; E John Orav; David W Bates; Steven R Simon Journal: J Am Med Inform Assoc Date: 2009-04-23 Impact factor: 4.497
Authors: Michelle Greiver; Jan Barnsley; Richard H Glazier; Rahim Moineddin; Bart J Harvey Journal: Can Fam Physician Date: 2011-10 Impact factor: 3.275
Authors: Lee A Green; Georges Potworowski; Anya Day; Rachelle May-Gentile; Danielle Vibbert; Bruce Maki; Leslie Kiesel Journal: Ann Fam Med Date: 2015 Jan-Feb Impact factor: 5.166
Authors: Derek W Meeks; Amirhossein Takian; Dean F Sittig; Hardeep Singh; Nick Barber Journal: J Am Med Inform Assoc Date: 2013-09-19 Impact factor: 4.497