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Implementing an electronic health record dashboard for safe anticoagulant management: learning from qualitative
Geoffrey D Barnes1,2,3, Emily Sippola4, Allison Ranusch5
1Frankel Cardiovascular Center, Department of Internal Medicine, University of Michigan, 2800 Plymouth Rd, B14 G214, Ann Arbor, MI, 48109-2800, USA. gbarnes@umich.edu.
Implementation Science Communications
|February 3, 2022
Summary
Implementing electronic health record (EHR) tools requires addressing clinician autonomy and integration barriers. Understanding pre- and post-implementation perspectives is crucial for successful digital health adoption.
Area of Science:
- Health Informatics
- Implementation Science
- Health Services Research
Background:
- The increasing use of electronic health record (digital health) tools for care delivery necessitates robust implementation frameworks.
- Existing determinants frameworks often overlook critical barriers in technology implementation.
Purpose of the Study:
- To identify key determinants of successful electronic health record (EHR) tool implementation.
- To compare implementation challenges in pre- and post-implementation settings for population health dashboards.
Main Methods:
- Conducted semi-structured interviews with 45 participants across two healthcare systems: Veterans Health Affairs (VA) post-implementation and Michigan Anticoagulation Quality Improvement Initiative (MAQI^2) pre-implementation.
- Employed rapid qualitative inquiry analysis and stakeholder focus groups to select implementation strategies.
Main Results:
- Identified five key determinants: clinician authority/autonomy, self-identity/job satisfaction, documentation needs, staffing, and system integration.
- Found context-specific differences in concerns regarding IT support, prioritization, and clinician authority between VA and MAQI^2.
Conclusions:
- Successful EHR tool implementation demands unique strategies, considering implementation status and impact on clinical staff autonomy.
- Integrating pre- and post-implementation user perspectives offers a comprehensive understanding of implementation determinants.
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