title: Evaluation of user adoption during three module deployments of region-wide electronic patient record systems.
abstract: BACKGROUND
  In Sweden there are modular region-wide EPR systems that are implemented at various health organisations in the region. The market is dominated by four IT systems that have been procured and deployed in 18 out of 21 regions.
  
  
  METHODS
  In a 2.5-year research study, deployments of three region-wide EPR modules: a patient administration system, eReferral module and eMedication module were followed and evaluated. Health professionals, EPR maintenance organisation, IT and health care managers were observed, interviewed and responded to questionnaires.
  
  
  RESULTS
  Although the same deployment process was used during the three deployments, large variations in the units' adoptions were observed. The variations were due to: (1) expectation and attitude, (2) management and steering, (3) end-user involvement, (4) EPR learning, and (5) usability and the possibility of changing and improving the EPR.
  
  
  CONCLUSIONS
  If changes in work processes are not considered in development and deployment, the potential benefits will not be achieved. It is therefore crucial that EPR deployment is conceived as organisational development. Users must be supported not just before and during the go-live phase, but also in the post-period. A problem often encountered is that it is difficult to make late changes in a region-wide EPR, and it is an open question whether it is possible to talk about a successful deployment if the usability of the introduced system is low.
authors.affiliation: Uppsala University, Department of Information Technology, Lägerhyddsvägen 2, 752 37 Uppsala, Sweden. Electronic address: rebecka.janols@it.uu.se.
authors.forename: Rebecka
authors.initials: R
authors.lastname: Janols
authors.affiliation: Uppsala University, Department of Information Technology, Lägerhyddsvägen 2, 752 37 Uppsala, Sweden. Electronic address: thomas.lind@it.uu.se.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lind
authors.affiliation: Uppsala University, Department of Information Technology, Lägerhyddsvägen 2, 752 37 Uppsala, Sweden. Electronic address: bengt.goransson@it.uu.se.
authors.forename: Bengt
authors.initials: B
authors.lastname: Göransson
authors.affiliation: Uppsala University, Department of Information Technology, Lägerhyddsvägen 2, 752 37 Uppsala, Sweden. Electronic address: bengt.sandblad@it.uu.se.
authors.forename: Bengt
authors.initials: B
authors.lastname: Sandblad
mesh_terms: D001291:Attitude of Health Personnel; D011307:Drug Prescriptions; D057286:Electronic Health Records / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data*; D006282:Health Personnel / Q000523:psychology*; D006301:Health Services Needs and Demand; D006801:Humans; D033181:Information Dissemination; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Hospital information systems; Human computer interaction; Medical health record, Computerized; Medical informatics; Organisational change; Technology adoption