title: A comparison of the adoption of electronic health records in North Carolina and South Carolina HIV systems.
abstract: BACKGROUND
  The electronic exchange of health records has been a notable topic in recent years in the effort to improve the quality of healthcare delivery and reduce administrative burden. Interviews and documents from stakeholders in human immunodeficiency virus (HIV) care, and HIV information technology were collected between November 2004 through March 2005 to conduct a qualitative policy analysis on the adoption of an electronic health record (EHR) system among HIV care providers in North Carolina and South Carolina.
  
  
  METHODS
  Interview data on the current state of EHR use were collected in February through June 2008. The case study analysis included description, categorical aggregation, and naturalistic generalization.
  
  
  RESULTS
  Naturalistic generalizations that emerged were (1) state-level policies can have a significant effect on successful adoption of EHRs; (2) state-level champions are integral to cross-sectoral, multi-institutional EHR adoption; (3) voluntary and mandatory adoption strategies can lead to successful cross-sectoral, multi-institutional EHR implementation.
  
  
  CONCLUSIONS
  State health departments can play an integral part in the successful implementation of EHR systems.
authors.affiliation: Duke Health Inequalities Program, Duke University Center for Health Policy, Durham, NC 27705, USA. mike.belden@gmail.com
authors.forename: Charles M
authors.initials: CM
authors.lastname: Belden
authors.forename: Rae Jean
authors.initials: RJ
authors.lastname: Proeschold-Bell
mesh_terms: D003266:Continuity of Patient Care; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000458:organization & administration*; D015658:HIV Infections / Q000628:therapy*; D006284:Health Plan Implementation / Q000458:organization & administration*; D006291:Health Policy; D006801:Humans; D008498:Medical Record Linkage; D009657:North Carolina; D019982:Organizational Case Studies; D013022:South Carolina