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The computerized patient record: balancing effort and benefit.

Astrid M van Ginneken1

  • 1Department of Medical Informatics, Erasmus University, P.O. Box 3000, DR, Rotterdam, The Netherlands. vanginneken@mi.fgg.eur.nl

International Journal of Medical Informatics
|June 8, 2002
PubMed
Summary

The slow adoption of computerized patient records (CPRs) stems from balancing effort and benefit for all parties, with insufficient return on investment and lack of integration being key barriers. Addressing these requires flexible architecture and user involvement for successful implementation.

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Area of Science:

  • Health Informatics
  • Medical Record Systems
  • Healthcare Technology Adoption

Background:

  • The potential of Computerized Patient Records (CPRs) for enhancing care quality and reducing costs is widely acknowledged.
  • However, the widespread adoption of CPRs has been notably slow, prompting an examination of the underlying challenges.
  • Key questions revolve around the reasons for this slow uptake and the influence of record architecture and standardization.

Purpose of the Study:

  • To investigate the reasons behind the slow introduction of CPRs despite their recognized benefits.
  • To analyze the role of record architecture and standardization in CPR adoption.
  • To identify barriers and requirements for successful CPR implementation and acceptance.

Main Methods:

  • This review synthesizes existing knowledge on CPR adoption, focusing on the relationship between effort, benefit, and stakeholder involvement.

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  • It examines financial impediments, such as insufficient return on investment.
  • It also addresses usability issues like lack of integration and flexibility, and the impact of standardization.

    • Main Results:

    • Significant barriers to CPR adoption include financial disincentives (poor ROI) and operational challenges (lack of integration, inflexibility).
    • Clinicians require sufficient reward and motivation to overcome the effort associated with data entry and workflow changes.
    • Lack of standardization hinders data exchange, and fear of technological obsolescence is a concern.

    Conclusions:

    • Effective CPR implementation necessitates a balance of effort and benefit for all stakeholders.
    • Key system requirements include flexibility, integration, and adaptability, best achieved through an architecture separating content and structure.
    • Successful adoption depends on independent evaluation and active user involvement in planning and prioritization.