title: Implementation of electronic medical records: theory-informed qualitative study.
abstract: OBJECTIVE
  To apply the diffusion-of-innovations theory to the examination of factors that are perceived by family physicians as influencing the implementation of electronic medical records (EMRs).
  
  
  METHODS
  Qualitative study with 2 focus groups 18 months after EMR implementation; participants also took part in a concurrent quantitative study examining EMR implementation and preventive services.
  
  
  METHODS
  Toronto, Ont.
  
  
  METHODS
  Twelve community-based family physicians.
  
  
  METHODS
  We employed a semistructured interview guide. The interviews were audiotaped and transcribed verbatim; 2 researchers independently categorized and coded the transcripts and then met to compare and contrast their findings, category mapping, and interpretations. Findings were then mapped to an existing theoretical framework.
  
  
  RESULTS
  Multiple barriers to EMR implementation were described. These included lack of relative advantage for many processes, high complexity of the system, low compatibility with physician needs and past experiences, difficulty with adaptation of the EMR to the organization and adaptation of the organization to the EMR, and lack of organizational slack. Positive factors were the presence of a champion and relative advantages for some processes.
  
  
  CONCLUSIONS
  Early EMR implementation experience is consistent with theoretical concepts associated with implementation of innovations. A problematic implementation process helps to explain, at least in part, the lack of improvement in preventive services in our quantitative results.
authors: Department of Family and Community Medicine, University of Toronto, Ontario, Canada. mgreiver@rogers.com
authors: Michelle
authors: M
authors: Greiver
authors: Jan
authors: J
authors: Barnsley
authors: Richard H
authors: RH
authors: Glazier
authors: Rahim
authors: R
authors: Moineddin
authors: Bart J
authors: BJ
authors: Harvey
mesh_terms: D005260:Female; D017144:Focus Groups / Q000379:methods*; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D009864:Ontario; D009936:Organizational Innovation; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research