title: A case study of an EMR system at a large hospital in India: challenges and strategies for successful adoption.
abstract: This paper presents an ethnographically inspired interpretive case study of the Electronic Medical Record (EMR) system at Sankara Nethralaya hospital in India. It presents challenges related to the adoption of the system and methods and strategies that were utilized in order to overcome these challenges and help the system be adopted successfully. One of the more notable challenges at the hospital was a user base that included skeptical users, those lacking computing skills, and that had a history of rejecting designs. Despite these barriers the hospital was able to adopt the EMR system successfully. Notable issues related to the success of the system include the design strategy that was eventually used, and critical technical and social features of the system intended to support skeptical users and those lacking IT skills. The study contributes to overall understanding of the environment at large hospitals in developing countries as it relates to the adoption of EMR systems, and helps inform on methods that can be used to improve the adoption of EMR systems in similar contexts in both developed and developing countries.
authors.affiliation: Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway and Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden. jeremiah.scholl@ki.se
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Scholl
authors.forename: Shabbir
authors.initials: S
authors.lastname: Syed-Abdul
authors.forename: Luai Awad
authors.initials: LA
authors.lastname: Ahmed
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003695:Delivery of Health Care / Q000458:organization & administration; D003906:Developing Countries; D006761:Hospitals; D006801:Humans; D007194:India; D016347:Medical Records Systems, Computerized / Q000458:organization & administration / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires