title: Assessing the process of designing and implementing electronic health records in a statewide public health system: the case of Colima, Mexico.
abstract: The findings of a case study assessing the design and implementation of an electronic health record (EHR) in the public health system of Colima, Mexico, its perceived benefits and limitations, and recommendations for improving the implementation process are presented. In-depth interviews and focus group discussions were used to examine the experience of the actors and stakeholders participating in the design and implementation of EHRs. Results indicate that the main driving force behind the use of EHRs was to improve reporting to the two of the main government health and social development programs. Significant challenges to the success of the EHR include resistance by physicians to use the ICD-10 to code diagnoses, insufficient attention to recurrent resources needed to maintain the system, and pressure from federal programs to establish parallel information systems. Operating funds and more importantly political commitment are required to ensure sustainability of the EHRs in Colimaima.
authors.affiliation: Information Center for Decisions in Public Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Juan Eugenio
authors.initials: JE
authors.lastname: Hernández-Ávila
authors.forename: Lina Sofia
authors.initials: LS
authors.lastname: Palacio-Mejía
authors.forename: Agustín
authors.initials: A
authors.lastname: Lara-Esqueda
authors.forename: Eva
authors.initials: E
authors.lastname: Silvestre
authors.forename: Marcela
authors.initials: M
authors.lastname: Agudelo-Botero
authors.forename: Mark L
authors.initials: ML
authors.lastname: Diana
authors.forename: David R
authors.initials: DR
authors.lastname: Hotchkiss
authors.forename: Beatriz
authors.initials: B
authors.lastname: Plaza
authors.forename: Alicia
authors.initials: A
authors.lastname: Sanchez Parbul
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D007255:Information Services; D008297:Male; D008800:Mexico; D008875:Middle Aged; D019982:Organizational Case Studies; D010820:Physicians; D011057:Politics; D017064:Process Assessment, Health Care; D040442:Public Health Informatics; D018581:Technology Transfer