QUESTION: Can community-based physiotherapists adopt and use a nationally integrated electronic health record (NEHR) system? DESIGN: Observation and semi-structured interviews in two community-based physiotherapy clinics in Sydney, Australia. PARTICIPANTS: Two physiotherapy practice managers who were also practising physiotherapists. INTERVENTION: The implementation of a nationally integrated EHR system in physiotherapy. OUTCOME MEASURES: Details of the adoption process, use of the EHR system, physiotherapists' satisfaction and concerns. RESULTS: Physiotherapists collaborated closely with the system engineer to guide the development, implementation and tests of the integrated EHR (iEHR) system. The system was successfully deployed and was used for the full one year trial as planned. Within the first month of operations, the clinics had completed the migration of their local databases to the iEHR system. The practice managers were satisfied with the documentation capacities of the iEHR system. However, the implementation was challenging and the eReferral and billing functions were not used because of unforeseen stakeholders' resistance. CONCLUSION: The iEHR system was deployed and operated in clinical practices for the full one year planned trial period. The stakeholders were satisfied with the experience they gained from using the iEHR system. They attributed their positive feelings with the opportunity to work collaboratively and in confidence with the system engineer. The implementation model used for this pilot project can be effectively adopted for the development of other types of information systems. The results of this case study imply that the main barriers to successful implementation of nationally integrated EHR systems are stakeholders' negative attitudes and lack of readiness for change.
QUESTION: Can community-based physiotherapists adopt and use a nationally integrated electronic health record (NEHR) system? DESIGN: Observation and semi-structured interviews in two community-based physiotherapy clinics in Sydney, Australia. PARTICIPANTS: Two physiotherapy practice managers who were also practising physiotherapists. INTERVENTION: The implementation of a nationally integrated EHR system in physiotherapy. OUTCOME MEASURES: Details of the adoption process, use of the EHR system, physiotherapists' satisfaction and concerns. RESULTS: Physiotherapists collaborated closely with the system engineer to guide the development, implementation and tests of the integrated EHR (iEHR) system. The system was successfully deployed and was used for the full one year trial as planned. Within the first month of operations, the clinics had completed the migration of their local databases to the iEHR system. The practice managers were satisfied with the documentation capacities of the iEHR system. However, the implementation was challenging and the eReferral and billing functions were not used because of unforeseen stakeholders' resistance. CONCLUSION: The iEHR system was deployed and operated in clinical practices for the full one year planned trial period. The stakeholders were satisfied with the experience they gained from using the iEHR system. They attributed their positive feelings with the opportunity to work collaboratively and in confidence with the system engineer. The implementation model used for this pilot project can be effectively adopted for the development of other types of information systems. The results of this case study imply that the main barriers to successful implementation of nationally integrated EHR systems are stakeholders' negative attitudes and lack of readiness for change.
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Keywords:
Electronic health record; adoption; clinical practice; implementation; information management; physiotherapist