title: The EHR's roles in collaboration between providers: A qualitative study.
abstract: OBJECTIVE
  Examine how the Electronic Health Record (EHR) and its related systems support or inhibit provider collaboration.
  
  
  BACKGROUND
  Health care systems in the US are simultaneously implementing EHRs and transitioning to more collaborative delivery systems; this study examines the interaction between these two changes.
  
  
  METHODS
  This qualitative study of five US EHR implementations included 49 interviews and over 60 hours of provider observation. We examined the role of the EHR in building relationships, communicating, coordinating, and collaborative decision-making.
  
  
  RESULTS
  The EHR plays four roles in collaboration: a repository, a messenger, an orchestrator, and a monitor. While EHR performance varied, common themes were decreased trust due to poor quality documentation, incomplete communication, potential for increased effectiveness through better coordination, and the emerging role of the EHR in identifying performance gaps.
  
  
  CONCLUSIONS
  Both organizational and technical innovations are needed if the EHR is to truly support collaborative behaviors.
authors.affiliation: Oregon Health & Science University, Portland, OR.
authors.forename: Dian A
authors.initials: DA
authors.lastname: Chase
authors.affiliation: Oregon Health & Science University, Portland, OR.
authors.forename: Joan S
authors.initials: JS
authors.lastname: Ash
authors.affiliation: Oregon Health & Science University, Portland, OR.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Cohen
authors.affiliation: Oregon Health & Science University, Portland, OR.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hall
authors.affiliation: University of California Irvine, Irvine, CA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Olson
authors.affiliation: Oregon Health & Science University, Portland, OR.
authors.forename: David A
authors.initials: DA
authors.lastname: Dorr
mesh_terms: D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D057286:Electronic Health Records; D006801:Humans; D033183:Interdisciplinary Communication; D018802:Patient-Centered Care / Q000458:organization & administration; D036301:Qualitative Research; D014481:United States