title: Implementing an electronic point-of-care medical record at an organized athletic event: challenges, pitfalls, and lessons learned.
abstract: OBJECTIVE
  We examined the feasibility of implementing an electronic health record (EHR) at an international running event.
  
  
  METHODS
  Institutional review board-approved observational study.
  
  
  METHODS
  An annual international running event supported by an on-site medical facility.
  
  
  METHODS
  All registered athletes.
  
  
  METHODS
  Web-based EHR provided at no cost. Participants were asked to populate it with essential health data. The EHR was accessed for runners requiring medical services.
  
  
  METHODS
  Obstacles to EHR utilization, reliability of EHR functionality in the field, and ability to correctly match runners to their EHR.
  
  
  RESULTS
  Only 320 (5%) of the participants utilized the EHR. Repeated notification, no cost, and ready access proved to be insufficient drivers for use. Lack of reliable Internet connectivity hampered full functionality. "Bib swapping" may pose a risk for participant misidentification with resultant electronic medical error.
  
  
  CONCLUSIONS
  Barriers to the successful utilization of an EHR were identified. Despite education and promotion, voluntary participant enrollment was a challenge. Mandatory enrollment will be required if universal EHR adoption is the goal. Internet connectivity needs to be logistically planned. Future efforts should focus on measures to ensure that EHRs are correctly matched to participants. Bib swapping must be eliminated if athletes are to be identified by their assigned numbers.
authors.affiliation: Department of Emergency Medicine, Maine Medical Center, Portland, Maine, USA.
authors.forename: Hamilton J
authors.initials: HJ
authors.lastname: Wells
authors.forename: George L
authors.initials: GL
authors.lastname: Higgins
authors.forename: Michael R
authors.initials: MR
authors.lastname: Baumann
mesh_terms: D057286:Electronic Health Records / Q000295:instrumentation / Q000458:organization & administration*; D005240:Feasibility Studies; D006801:Humans; D038622:Internationality; D020407:Internet; D008281:Maine; D019095:Point-of-Care Systems / Q000458:organization & administration*; D011446:Prospective Studies; D012420:Running / Q000502:physiology*; D013177:Sports / Q000502:physiology*