A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.

<h4>Aims</h4>To investigate the perceptions and reported practices of mental health hospital staff using national hospital electronic health records (EHRs) in order to inform future implementations, particularly in acute mental health settings.<h4>Methods</h4>Thematic analysi...

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Autores principales:	Gloria Ser, Ann Robertson, Aziz Sheikh
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c92b747fe8f94ee19af72fad9bf298c0
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spelling	oai:doaj.org-article:c92b747fe8f94ee19af72fad9bf298c02021-11-18T08:37:34ZA qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.1932-620310.1371/journal.pone.0077669https://doaj.org/article/c92b747fe8f94ee19af72fad9bf298c02014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24454678/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Aims</h4>To investigate the perceptions and reported practices of mental health hospital staff using national hospital electronic health records (EHRs) in order to inform future implementations, particularly in acute mental health settings.<h4>Methods</h4>Thematic analysis of interviews with a wide range of clinical, information technology (IT), managerial and other staff at two early adopter mental health National Health Service (NHS) hospitals in London, UK, implementing national EHRs.<h4>Results</h4>We analysed 33 interviews. We first sought out examples of workarounds, such as delayed data entry, entering data in wrong places and individuals using the EHR while logged in as a colleague, then identified possible reasons for the reported workarounds. Our analysis identified four main categories of factors contributing to workarounds (i.e., operational, cultural, organisational and technical). Operational factors included poor system integration with existing workflows and the system not meeting users' perceived needs. Cultural factors involved users' competence with IT and resistance to change. Organisational factors referred to insufficient organisational resources and training, while technical factors included inadequate local technical infrastructure. Many of these factors, such as integrating the EHR system with day-to-day operational processes, staff training and adequate local IT infrastructure, were likely to apply to system implementations in various settings, but we also identified factors that related particularly to implementing EHRs in mental health hospitals, for example: EHR system incompatibility with IT systems used by mental health-related sectors, notably social services; the EHR system lacking specific, mental health functionalities and options; and clinicians feeling unable to use computers while attending to distressed psychiatric patients.<h4>Conclusions</h4>A better conceptual model of reasons for workarounds should help with designing, and supporting the implementation and adoption of, EHRs for use in hospital mental health settings.Gloria SerAnn RobertsonAziz SheikhPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e77669 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Gloria Ser Ann Robertson Aziz Sheikh A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.
description	<h4>Aims</h4>To investigate the perceptions and reported practices of mental health hospital staff using national hospital electronic health records (EHRs) in order to inform future implementations, particularly in acute mental health settings.<h4>Methods</h4>Thematic analysis of interviews with a wide range of clinical, information technology (IT), managerial and other staff at two early adopter mental health National Health Service (NHS) hospitals in London, UK, implementing national EHRs.<h4>Results</h4>We analysed 33 interviews. We first sought out examples of workarounds, such as delayed data entry, entering data in wrong places and individuals using the EHR while logged in as a colleague, then identified possible reasons for the reported workarounds. Our analysis identified four main categories of factors contributing to workarounds (i.e., operational, cultural, organisational and technical). Operational factors included poor system integration with existing workflows and the system not meeting users' perceived needs. Cultural factors involved users' competence with IT and resistance to change. Organisational factors referred to insufficient organisational resources and training, while technical factors included inadequate local technical infrastructure. Many of these factors, such as integrating the EHR system with day-to-day operational processes, staff training and adequate local IT infrastructure, were likely to apply to system implementations in various settings, but we also identified factors that related particularly to implementing EHRs in mental health hospitals, for example: EHR system incompatibility with IT systems used by mental health-related sectors, notably social services; the EHR system lacking specific, mental health functionalities and options; and clinicians feeling unable to use computers while attending to distressed psychiatric patients.<h4>Conclusions</h4>A better conceptual model of reasons for workarounds should help with designing, and supporting the implementation and adoption of, EHRs for use in hospital mental health settings.
format	article
author	Gloria Ser Ann Robertson Aziz Sheikh
author_facet	Gloria Ser Ann Robertson Aziz Sheikh
author_sort	Gloria Ser
title	A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.
title_short	A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.
title_full	A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.
title_fullStr	A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.
title_full_unstemmed	A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.
title_sort	qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/c92b747fe8f94ee19af72fad9bf298c0
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A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals.

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