title: Implementation of an electronic medical record system in previously computer-naïve primary care centres: a pilot study from Cyprus.
abstract: BACKGROUND
  The computer-based electronic medical record (EMR) is an essential new technology in health care, contributing to high-quality patient care and efficient patient management. The majority of southern European countries, however, have not yet implemented universal EMR systems and many efforts are still ongoing. We describe the development of an EMR system and its pilot implementation and evaluation in two previously computer-naïve public primary care centres in Cyprus.
  
  
  METHODS
  One urban and one rural primary care centre along with their personnel (physicians and nurses) were selected to participate. Both qualitative and quantitative evaluation tools were used during the implementation phase. Qualitative data analysis was based on the framework approach, whereas quantitative assessment was based on a nine-item questionnaire and EMR usage parameters.
  
  
  RESULTS
  Two public primary care centres participated, and a total often health professionals served as EMR system evaluators. Physicians and nurses rated EMR relatively highly, while patients were the most enthusiastic supporters for the new information system. Major implementation impediments were the physicians' perceptions that EMR usage negatively affected their workflow, physicians' legal concerns, lack of incentives, system breakdowns, software design problems, transition difficulties and lack of familiarity with electronic equipment.
  
  
  CONCLUSIONS
  The importance of combining qualitative and quantitative evaluation tools is highlighted. More efforts are needed for the universal adoption and routine use of EMR in the primary care system of Cyprus as several barriers to adoption exist; however, none is insurmountable. Computerised systems could improve efficiency and quality of care in Cyprus, benefiting the entire population.
authors.affiliation: Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece. george.samoutis@gmail.com
authors.forename: George
authors.initials: G
authors.lastname: Samoutis
authors.forename: Elpidoforos S
authors.initials: ES
authors.lastname: Soteriades
authors.forename: Dimitris K
authors.initials: DK
authors.lastname: Kounalakis
authors.forename: Theodora
authors.initials: T
authors.lastname: Zachariadou
authors.forename: Anastasios
authors.initials: A
authors.lastname: Philalithis
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003258:Consumer Behavior; D003535:Cyprus; D004868:Equipment Failure; D005260:Female; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D008875:Middle Aged; D009726:Nurses; D010820:Physicians; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*