The Use of Case Studies in Systems Implementations Within Health Care Settings: A Scoping Review

There is little evidence available in the research literature as to how to undertake an implementation process that ensures electronic medical record (EMR)/electronic health record (EHR) implementation success (i.e. high levels of clinician adoption). The research literature has documented the presence of a direct relationship between how systems are implemented and their level of adoption by clinicians after implementation. In order to develop recommendations for systems implementation to enhance the level of clinician adoption and to ensure EHR/EMR success, researchers need to analyze implementation failures (i.e. where there has been a low level of adoption among clinicians) and successes (i.e. where there has been a high level of clinician adoption). This paper examines EMR/EHR system implementation in the context of adoption success, by conducting a scoping review of the EMR/EHR case study literature. The paper attempts to answer the following: "How does the published, case study research literature provide insights into the success and/or failure of EMR/EHR implementations?" Case studies can provide insights that allow researchers to identify best practice approaches to EMR/EHR implementations that may turn the tide towards reducing the number failed EMR/EHR implementation projects.