title: Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study.
abstract: BACKGROUND
  Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular.
  
  
  METHODS
  The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis.
  
  
  RESULTS
  Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general.
  
  
  CONCLUSIONS
  The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange can be improved by developing tools to evaluate the legitimacy of access to electronic records, by increasing health care providers' awareness of the need to be careful when using patient data, and by measures to limit access to sensitive patient data. Improving health care providers' recording behaviour is important to improve the reliability and quality of electronically exchanged patient data.
authors: NIVEL, Netherlands Institute for Health Services Research, P,O, Box 1568, 3500 BN Utrecht, the Netherlands. m.zwaanswijk@nivel.nl
authors: Marieke
authors: M
authors: Zwaanswijk
authors: Robert A
authors: RA
authors: Verheij
authors: Floris J
authors: FJ
authors: Wiesman
authors: Roland D
authors: RD
authors: Friele
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D006282:Health Personnel / Q000458:organization & administration*; D006751:Hospital Information Systems / Q000458:organization & administration; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D008297:Male; D009426:Netherlands; D011787:Quality of Health Care; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity