title: Electronic health records: what are the most important barriers?
abstract: BACKGROUND
  The process of design and adoption of electronic health records may face a number of barriers. This study aimed to compare the importance of the main barriers from the experts' point of views in Iran.
  
  
  METHODS
  This survey study was completed in 2011. The potential participants (62 experts) included faculty members who worked in departments of health information technology and individuals who worked in the Ministry of Health in Iran and were in charge of the development and adoption of electronic health records. No sampling method was used in this study. Data were collected using a Likert-scale questionnaire ranging from 1 to 5. The validity of the questionnaire was established using content and face validity methods, and the reliability was calculated using Cronbach's alpha coefficient.
  
  
  RESULTS
  The response rate was 51.6 percent. The participants' perspectives showed that the most important barriers in the process of design and adoption of electronic health records were technical barriers (mean = 3.84). Financial and ethical-legal barriers, with the mean value of 3.80 were other important barriers, and individual and organizational barriers, with the mean values of 3.59 and 3.50 were found to be less important than other barriers from the experts' perspectives.
  
  
  CONCLUSIONS
  Strategic planning for the creation and adoption of electronic health records in the country, creating a team of experts to assess the potential barriers and develop strategies to eliminate them, and allocating financial resources can help to overcome most important barriers to the adoption of electronic health records.
authors.affiliation: Haleh Ayatollahi, MSc, PhD, is an assistant professor of medical informatics in the Department of Health Information Management at Iran University of Medical Sciences in Tehran, Iran.
authors.forename: Haleh
authors.initials: H
authors.lastname: Ayatollahi
authors.affiliation: Nader Mirani, MSc, is a PhD student in the School of Health Management and Information Sciences at Iran University of Medical Sciences in Tehran, Iran.
authors.forename: Nader
authors.initials: N
authors.lastname: Mirani
authors.affiliation: Hamid Haghani, MSc, is a lecturer in mathematics and statistics in the Department of Mathematics and Statistics in the School of Health at Iran University of Medical Sciences in Tehran, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Haghani
mesh_terms: D000328:Adult; D016494:Computer Security; D003219:Confidentiality; D057286:Electronic Health Records / Q000191:economics / Q000941:ethics / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000191:economics / Q000941:ethics / Q000458:organization & administration*; D018511:Systems Integration
keywords: electronic health records; health information system; health information technology; medical informatics