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Lookup NU author(s): Professor Sarah Slight
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We conducted a prospective evaluation of different forms of electronic health record (EHR) systems to better understand the costs incurred during implementation and the factors that can influence these costs. We selected a range of diverse organizations across three different geographical areas in England that were at different stages of implementing three centrally procured applications, that is, iSOFT's Lorenzo Regional Care, Cerner's Millennium, and CSE's RiO. 41 semi-structured interviews were conducted with hospital staff, members of the implementation team, and those involved in the implementation at a national level. Four main overarching cost categories were identified: infrastructure (eg, hardware and software), personnel (eg, training team), estates/facilities (eg, space), and other (eg, training materials). Many factors were felt to impact on these costs, with different hospitals choosing varying amounts and types of infrastructure, diverse training approaches for staff, and different software applications to integrate with the new system. Improving the quality and safety of patient care through EHR adoption is a priority area for UK and US governments and policy makers worldwide. With cost considered one of the most significant barriers, it is important for hospitals and governments to be clear from the outset of the major cost categories involved and the factors that may impact on these costs. Failure to adequately train staff or to follow key steps in implementation has preceded many of the failures in this domain, which can create new safety hazards. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Author(s): Slight SP, Quinn C, Avery AJ, Bates DW, Sheikh A
Publication type: Article
Publication status: Published
Journal: Journal of the American Medical Informatics Association : JAMIA
Year: 2014
Volume: 21
Issue: e2
Pages: e226–e231
Print publication date: 01/10/2014
Online publication date: 12/02/2014
Acceptance date: 23/12/2013
ISSN (print): 1067-5027
ISSN (electronic): 1527-974X
Publisher: BMJ Publishing Group Limited
URL: https://doi.org/10.1136/amiajnl-2013-002404
DOI: 10.1136/amiajnl-2013-002404
PubMed id: 24523391
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