title: End-user support for a primary care electronic medical record: a qualitative case study of a vendor's perspective.
abstract: BACKGROUND
  In primary care settings, users often rely on vendors to provide support for health information technology (HIT). Yet, little is known about the vendors' perspectives on the support they provide, how support personnel perceive their roles, the challenges they face and the ways they deal with them.
  
  
  OBJECTIVE
  To provide in-depth insight into an electronic medical record (EMR) vendor's perspective on end-user support.
  
  
  METHODS
  As part of a larger case study research, we conducted nine semi-structured interviews with help desk staff, trainers and service managers of an EMR vendor, and observed two training sessions of a new client.
  
  
  RESULTS
  With a growing client base, the vendor faced challenges of support staff shortage and high variance in users' technical knowledge. Additionally, users sometimes needed assistance with infrastructure, and not just software problems. These challenges sometimes hindered the provision of timely support and required supporters to possess good interpersonal skills and adapt to diverse client population.
  
  
  CONCLUSIONS
  This study highlights the complexity of providing end-user support for HIT. With increased adoption, other vendors are likely to face similar challenges. To deal with these issues, supporters need not only strong technical knowledge of the systems, but also good interpersonal communication skills. Some responsibilities may be delegated to super-users. Users may find it useful to hire local IT staff, at least on an on-call basis, to provide assistance with infrastructure problems, which are not supported by the software vendor. Vendors may consider expanding their service packages to cover these elements.
authors.affiliation: Faculty of Information, University of Toronto, Canada, ON M5T 3M6, Canada. aviv.shachak@utoronto.ca
authors.forename: Aviv
authors.initials: A
authors.lastname: Shachak
authors.forename: Jan
authors.initials: J
authors.lastname: Barnsley
authors.forename: Catherine
authors.initials: C
authors.lastname: Montgomery
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
authors.forename: Alejandro R
authors.initials: AR
authors.lastname: Jadad
authors.forename: Louise
authors.initials: L
authors.lastname: Lemieux-Charles
mesh_terms: D003132:Commerce; D057286:Electronic Health Records; D006801:Humans; D007407:Interviews as Topic; D011320:Primary Health Care; D036301:Qualitative Research; D012984:Software