The Journey through Grief: Insights from a Qualitative Study of Electronic Health Record Implementation
Open Access
- 15 September 2014
- journal article
- Published by Wiley in Health Services Research
- Vol. 50 (2), 462-488
- https://doi.org/10.1111/1475-6773.12227
Abstract
To improve understanding of facilitators of EHR system implementation, paying particular attention to opportunities to maximize physician adoption and effective deployment. Primary data collected from 47 physician and 35 administrative key informants from six U.S. health care organizations identified because of purported success with EHR implementation. We conducted interviews and focus groups in an extensive qualitative study. Verbatim transcripts were analyzed both deductively and inductively using the constant comparative method. Conceptualizing EHR adoption as loss through the lens of Kübler-Ross's five stages of grief model may help individuals and organizations more effectively orient to the challenge of change. Coupled with Kotter's eight-step change management framework, we offer a structure to facilitate organizations' movement through the EHR implementation journey. Combining insights from these frameworks, we identify 10 EHR strategies that can help address EHR implementation barriers. Loss is one part of change often overlooked. Addressing it directly and compassionately can potentially facilitate the EHR implementation journey. We offer a summarized list of deployment strategies that are sensitive to these issues to support physician transition to new technologies that will bring value to clinical practice.Keywords
This publication has 30 references indexed in Scilit:
- The Role of Cognitive and Learning Theories in Supporting Successful EHR System Implementation TrainingMedical Care Research and Review, 2012
- Electronic health records in small physician practices: availability, use, and perceived benefitsJournal of the American Medical Informatics Association, 2011
- 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics systemImplementation Science, 2010
- Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventionsBMC Health Services Research, 2010
- Resistance Is Futile: But It Is Slowing the Pace of EHR Adoption NonethelessJournal of the American Medical Informatics Association, 2009
- How to successfully select and implement electronic health records (EHR) in small ambulatory practice settingsBMC Medical Informatics and Decision Making, 2009
- Exploring antecedents of individual grieving stages during an anticipated worksite closureJournal of Occupational and Organizational Psychology, 2008
- Electronic Health Records in Ambulatory Care — A National Survey of PhysiciansThe New England Journal of Medicine, 2008
- Managing Successful Organizational Change in the Public SectorPublic Administration Review, 2006
- Qualitative Analysis as a Public Event: The Documentation of Category Development ProceduresAmerican Educational Research Journal, 1992