title: Techniques to aid the implementation of novel clinical information systems: a systematic review.
abstract: BACKGROUND
  This systematic review identifies and evaluates techniques that aid the implementation of novel clinical information systems (CIS) within healthcare.
  
  
  METHODS
  We searched electronic databases (MEDLINE, EMBASE, PsycINFO and HMIC Health Management Information Consortium). Desktop reviews for all potentially eligible studies were also conducted via reference lists and forward citation searches. 14,198 abstracts were identified through the initial electronic search. 63 articles were retained following title and abstract reviews, and submitted for full text evaluation. Of these, 18 papers met eligibility criteria.
  
  
  RESULTS
  The 5 techniques that emerged from the review and that can assist CIS implementation were: system piloting, eliciting acceptance, use of simulation, training and education, and provision of incentives. These techniques were evaluated with a range of study endpoints (including system utilisation, clinical effectiveness, user satisfaction, attitudes towards system training, and attitudes towards implementation). Consideration of the clinical context in which the CIS was implemented was a consistent theme in the evidence-base.
  
  
  CONCLUSIONS
  Although some evidence is available for the effectiveness of the 5 implementation techniques found in this review, the variable endpoints and the non-comparable study designs mean that the evidence-base needs further developing. We discuss the potential role of simulation and clinical leadership, particularly in relation to surgeons, in CIS implementation and we propose practical advice for CIS implementation and evaluation within hospital settings.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, UK. Electronic address: t.kelay@imperial.ac.uk.
authors.forename: Tanika
authors.initials: T
authors.lastname: Kelay
authors.forename: Sujatha
authors.initials: S
authors.lastname: Kesavan
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Collins
authors.forename: Jimmy
authors.initials: J
authors.lastname: Kyaw-Tun
authors.forename: Benita
authors.initials: B
authors.lastname: Cox
authors.forename: Fernando
authors.initials: F
authors.lastname: Bello
authors.forename: Roger L
authors.initials: RL
authors.lastname: Kneebone
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
mesh_terms: D006801:Humans; D008490:Medical Informatics; D018511:Systems Integration
keywords: Clinical information systems; Clinical leadership; Clinical safety; Patient safety