We summarise a recent study, published in BMC Health Services Research, that explored the factors influencing the adoption of an electronic medical record (EMR) in a cancer centre.
EMR
Digital technologies are becoming increasingly adopted within healthcare. This digital transformation has led to increased personalisation of healthcare and the potential for new approaches to improve patient care. EMRs are computerised information systems that collect, store and display patients’ information. They are key enablers of the data revolution that is transforming the health sector. There are several benefits of using EMRs. These include improving quality of care, improving timely access to data and facilitating knowledge exchange for collaboration in multidisciplinary teams.
Nonetheless, healthcare workers can only harness these benefits if EMRs are implemented and currently there is an apparent gap in understanding the best way to do this. The implementation of EMRs is complex and requires consideration of a range of technical, human and organisational factors. Most research explores the barriers and enablers in relation to primary care, with little research on the implementation of EMRs in cancer care.
Barriers and enablers
In this study, researchers undertook a qualitative study collecting data on the experiences of clinical and administrative staff at pre- and post- launch of a new EMR. Specifically, the team undertook interviews with 12 clinical and administrative staff from a cancer centre.
The data from pre-implementation was categorised into the following:
- Awareness and understanding of EMRs – The majority of participants were enthusiastic about the potential EMR. But many acknowledged uncertainties about the additional capabilities.
- Engagement in launch process – All participants indicated that they had been engaged on some level during the implementation process.
- Standardisation and completeness of data – Participants perceived the EMR to be beneficial for improving the quality of clinical data collected within their centre in the future. Some participants however raised concerns that the EMR was not integrated with other clinical data.
- Effect on workload – Generally, participants were concerned that the EMR may negatively impact workload.
The data from post-launch was categorised into the following:
- Standardisation and completeness of data – Participants indicated benefits of interoperability with the main hospital EMR and centre-wide access. The EMR was noted as valuable for improving completeness of data.
- Effect on workload – Participants noted increased efficiency and reduced risk of errors. Concerns were however raised about the unexpected issues when the new EMR did not allow staff to complete simple tasks that were previously automated.
- Feature completeness and functionality – A number of participants raised concerns about issues with features, or functionality of features in the EMR. A significant concern was the lack of the patient summary page.
- Interaction with technical support – Some noted a lack of technical support once the EMR was launched.
- Learning curve – There were some concerns about the difficulty in remembering how to enter data into the new EMR fields. This was particularly the case for staff that didn’t interact with it regularly.
- Buy-in from staff – Some participants raised concerns about lack of buy-in to the EMR across clinical disciplines that work within and in collaboration within the centre.
Conclusion
These findings contribute to new knowledge on the barriers and enablers to the implementation of EMRs in complex clinical settings. The main barriers to successful implementation included lack of technical support, increased workload and familiarisation with using the EMR. Moreover, the main enablers included clinician engagement in the design and roll-out of the EMR and training of all end-users. The effective use and standardisation of EMRs across healthcare systems will provide great opportunities within biomedical research and drug discovery.
Image credit: By pandpstock001 – canva.com
