title: The journey from precontemplation to action: Transitioning between electronic medical record systems.
abstract: BACKGROUND
  Health care organizations, in response to federal programs, have sought to identify electronic medical record (EMR) strategies that align well with their visions for success. Little exists in the literature discussing the transition from one EMR strategy to another.
  
  
  OBJECTIVE
  The analysis and planning process used by a major academic medical center in its journey to adopt a new strategy was described in this study. We use the transtheoretical model of change to frame the five phases through which the organization transitioned from a best-of-breed system to an enterprise system.
  
  
  METHODS
  We explore the five phases of change from the perspective of a maturing approach to new technology adoption. Data collection included archival retrieval and review as well as interviews with key stakeholders.
  
  
  RESULTS
  Although there was always a focus on some enterprise capabilities such as computerized physician order entry, the emphasis on EMR selection tended to be driven by specialty requirements. Focusing on the patient across the continuum of care, as opposed to focusing on excessive requirements by clinical specialties, was essential in forming and deploying a vision for the new EMR.
  
  
  CONCLUSIONS
  This research outlines a successful pathway used by an organization that had invested heavily in EMR technology and was faced with evaluating whether to continue that investment or start with a new platform. Rather than focusing on the technology alone, efforts to reframe the discussion to one that focused on the patient resulted in less resistance to change.
authors.affiliation: Thomas Bentley, RN, MS, is Deputy CIO, Applications, The Ohio State University Wexner Medical Center, Columbus. Milisa Rizer, MD, MPH, is Chief Medical Information Officer, and Associate Professor of Family Medicine, The Ohio State University Wexner Medical Center, Columbus. Ann Scheck McAlearney, ScD, MS, is Professor of Family Medicine and Vice Chair for Research, Department of Family Medicine, The Ohio State University, Columbus. Hagop Mekhjian, MD, is Senior Associate Vice President, Health Sciences, The Ohio State University Wexner Medical Center, Columbus. Monica Siedler, MHA, is Administrative Associate, The Ohio State University Wexner Medical Center, Columbus. Karen Sharp, MS, is Director of Information Technology, The Ohio State University Wexner Medical Center, Columbus. Phyllis Teater, MS, is Associate Vice President, Health Services, The Ohio State University Wexner Medical Center, Columbus. Timothy Huerta, PhD, MS, is Associate Professor of Family Medicine and Biomedical Informatics, The Ohio State University, Columbus. Email: timothy.huerta@osumc.edu.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bentley
authors.forename: Milisa
authors.initials: M
authors.lastname: Rizer
authors.forename: Ann Scheck
authors.initials: AS
authors.lastname: McAlearney
authors.forename: Hagop
authors.initials: H
authors.lastname: Mekhjian
authors.forename: Monica
authors.initials: M
authors.lastname: Siedler
authors.forename: Karen
authors.initials: K
authors.lastname: Sharp
authors.forename: Phyllis
authors.initials: P
authors.lastname: Teater
authors.forename: Timothy
authors.initials: T
authors.lastname: Huerta
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D004059:Diffusion of Innovation; D057286:Electronic Health Records; D006801:Humans; D016347:Medical Records Systems, Computerized; D009820:Ohio; D015279:Organizational Culture; D009936:Organizational Innovation; D018802:Patient-Centered Care; D010934:Planning Techniques; D016730:Program Development / Q000379:methods*