Training for Electronic Health Record (EHR) has been recognized as a key facilitator to ensure optimum use and satisfaction with technology. However, research on the ways in which training can promote user satisfaction with technology and a smooth transition to EHR is lacking. This study aims to expand the available literature on the delivery of effective EHR training. End-users may still not perceive the values that EHR can bring to healthcare by improving quality of care and streamlining the delivery of services, although these values are well established. Several barriers can account for the lack of perception, including limited resources, lack of organizational support, and poor clinical ownership of technology. Training provides an excellent tool to communicate the initiatives behind technology implementation, to help users understand the benefits that EHR can bring, and ultimately to improve the satisfaction of the end-users with technology and enhance their adoption. The organizations implementing EHR need to focus on delivery of effective training by allocating sufficient time and resources to training. Trainers need to link with users by understanding different learning styles and adult learning principles, and practicing these principles to support different training methods. / Graduate / 0758 / 0710 / 0723 / 0530

<p>Electronic Health Record Systems (EHRs) are an important tool for today’s physicians. EHRs (commonly called EMRs in Canada) are used to store, retrieve and leverage patient information to achieve better clinical outcomes for patients. EHRs can also contribute to public policy by helping policy makers track population health data. There are barriers as well as drivers to successful implementation of EHRs. Also, with the introduction of EHRs and their accumulation of patient data physicians face challenges for better extraction and use of data as well as overall management of information within the clinic.</p> <p>This thesis performs a literature review and presents evidence on the barriers and drivers that exist in the area of EHR (Electronic Health Records) implementation in the US. The thesis also includes a survey that tracks responses of primary care physicians in the US. The responses were analyzed to determine key factors impacting EHR implementation and information management. The key factors included workflow, optimization of information technology (IT) resources that include software, hardware assets and trained personnel, and plan for extraction of data. Our research found, among other things, the need to raise awareness among physicians about optimizing clinical workflow, management of information in the EHRs, the need for additional training on the EHRs and, in case of non-urban physicians, the need for improved levels of IT and Internet expertise in the clinic.</p> / Master of Science (MSc)

This degree project deals with electronic health record (EHR). The report is divided into two main sections; literature study on electronic health record and an EHR system implementation. In the literature study section, EHR background, development history and service condition are introduced. The paper focuses on the sharing of medical information in different users, data safety and privacy. The adjunctions of computer science, technologies are used to solve the medical informatics’ problems. In the implementation section, based on the study of the current EHR systems, the design and implement of a shared EHR system are presented, which can be accessed by different doctors and patients. Access control function and cryptography protections are included in this system. The system test and evaluation are also given.

Effective chronic disease management ensures better treatment and reduces medical costs. Representing knowledge through building an ontology for Electronic Medical Records (EMRs) is important to achieve semantic interoperability among healthcare information systems and to better execute decision support systems. In this thesis, an ontology-based EMR focusing on Chronic Disease Management is proposed. The W3C Computer-based Patient Record ontology [32] is customized and augmented with concepts and attributes from the Western Health Infostructure Canada chronic disease management model [27] and the American Society for Testing and Materials International EHR. The result is an EMR ontology capable of representing knowledge about chronic disease. All of the clinical actions of the proposed ontology were found to map to HL7 RIM classes. Such an EMR ontology for chronic disease management can support reasoning for clinical decision support systems as well as act as a switching language from one EMR standard to another for chronic disease knowledge.

The implementation of Electronic Document Management Systems (EDMSs) is a complex process. Scripps Health started a project to implement the web based McKesson Horizon Patient Folder (HPF) software system in early 2011 in order to digitally capture all the information in patient charts. This research used semi-structured interviews to assess the perceived benefits of using an EDMS and its effect on work-flow from the perspective of physicians and health information management (HIM) staff at two hospitals in San Diego, California. The study was designed to assess the new work-flow processes, work-flow challenges associated with EDMS implementation, and other key factors associated with successful implementation of such systems. The research found the opinion of physicians and HIM staff about the effect of an EDMS on their work-flow to be mostly positive. The data analysis further showed that perceived benefits of an EDMS included improved patient care quality and patient care efficiency due to capabilities such as immediate access to patient information by multiple users, reduced patient data error and improved communication between HIM staff and physicians. The analysis of study data also highlighted some shortcomings of EDMSs; these included the system not being user friendly, not having full EMR capabilities and benefits and the inability of EDMSs to interface with other existing systems. The study proposes that despite some challenges post implementation, overall, an EDMS is favoured over paper based chart system. / Graduate / 0566 / 0769 / maryam.katani@gmail.com

This thesis examines the potential interface that exists between health information, specifically electronic health record (EHR) systems, and notifiable disease surveillance in Canada. It aims to highlight the benefits and barriers experienced by the current national notifiable disease surveillance strategy, as well as to highlight the successes and roadblocks to the successful implementation and adoption of EHR technologies in Canada. Qualitative methodologies, which include the 16 semi-structured interviews conducted with four key stakeholder groups, including public health experts, physicians, health administrators and academics that are concerned with EHR adoption and public health were used to obtain data. Data from interviews was analysed using grounded theory methodology and then verified using member checking and other data validation methods. Emergent themes from obtained data indicated that there is a large potential for the improvement of the current notifiable disease through the use of EHR technologies: however, the barriers currently faced by both the notifiable disease surveillance system and the state of implementation and adoption of EHR technologies prevent this from occurring. These barriers include political, financial, human, security/privacy, and technology barriers. Differences between stakeholder groups were explored, and potential solutions and insights into existing barriers were provided. The information gained from this study provides insight into the efficiency of the current infectious disease surveillance system and the progress of and need for the implementation of EHRs nationwide. In addition, the results of this study provide stakeholders with a deeper understanding of the barriers facing the use of EHR technologies for infectious disease surveillance and provide a starting place to address these issues. The results of this study can help to inform policy regarding public health surveillance and EHR implementation and adoption.

Magister Commercii - MCom / This study aimed to understand the readiness and perceptions of Electronic Health Record (EHR) adoption among dentists in the public service of the Western Cape. A qualitative study design was chosen due to a lack of understanding of the phenomena. Additionally, the research sought to identify the factors that would potentially influence readiness and perceptions in order to identify how these factors could potentially influence EHR adoption among dentists.

Nowadays, the main concern for any service provider organization is to improve their services with reducing the time of service accompanying with increase in their efficiency and effectiveness. In healthcare systems, specially, these concerns are much more important where the information is the core material of providng services to patients. Electronic health record (EHR) systems are designed to address these concerns and using them is becoming more and more important for many countries. EHR systems provide many capabilities to hospitals with collecting, sharing and manipulating information in the digitals format. Moreover, actual EHR systems enable hospitals to share their patient information with any other hospital no matter of the first location of storing data. Incorporating a system with the main goal of making integrity between different organizations is not an easy task and many challenges and problems should be considered to make the system efficient for the organizations. Although many good attempts have been done in some developing countries such as Denmark and USA this issue is still a big challenge for many developing countries. In this research study, it is tried to review the situation of EHR systems in a developing country to extract the challenges and barriers for adopting it. At first, the researcher has a deep literature review on past works on EHR from different aspects. After extracting needed information, a case study will be run to better understanding of the real situation and make a comparison between the literature and real environment. The researcher selected Iran as a developing country to review its healthcare system and the degree of using computerized system in the organizations. / Program: Magisterutbildning i informatik

More than 4.9 million businesses exist in the United States, and leaders within these businesses have to acclimate to change. Clear and effective communication is vital to the success of an organization. According to scholars and health care leaders focusing on strategies to communicate change during organizational change is a critical aspect of sustainability and profitability. The conceptual framework of this study was communication theory. The purpose of this single case study was to explore successful strategies that some health care leaders used to communicate during organizational change in a health care organization in El Paso, Texas. The data collection process consisted of collecting data from semistructured interviews and organizational documents, and the analysis process included grouping key words and reconstructing data into themes. The 4 key themes that emerged from this process included building trust through organizational communication is critical during change, the use of technologies, as a tool for communication is key during change, 2-way communication needs to occur during organizational change, and communication about change is vital through comprehensive organizational meetings. Health care leaders provided insights on management and communication strategies and responsibilities leaders and employees go through during organizational change. The implications for positive social change include strategies to improve communication that could help health care leaders with their employees and their patients during organizational change, which could increase the profitability of the organization and potentially generate a more thriving and healthy community.

A need for improvement in nursing education regarding inpatient workflows and informatics skills was identified at this project site. Upon hire, nurses were required to complete a 4-hour basic class on the electronic health record (EHR) system, but this class did not include inpatient-nursing workflows needed to provide and facilitate care for patients. This project addressed the lack of EHR education on inpatient nursing workflows. The focus of this staff education project was an education class on inpatient nursing workflow provided to a nurse residency class. Sources of evidence were obtained through a literature search and pretest/post test data analysis. The literature used to support the project included articles on best practices for EHR education for nursing. The pretest and post test design was used to determine if there was an increase in EHR knowledge after the education. Benner's novice-to- expert model served as the framework. The mean total proficiency scores on inpatient nursing workflows in the EHR improved from pretesting to post testing, (6.8 to 7.8, p = 0.048). The study findings showed improvement in participants' average proficiency, knowledge, and clinical skills in the EHR. This project findings demonstrated the need for an inpatient nursing informatics workflow class for all nursing staff, and the findings supported an increase in education to facilitate workflow and care safety. This project promotes positive social change by improving curricula, raising awareness of how technology affects clinical care and practice, and encouraging continuous quality improvement through informatics education.