title: End-user support for primary care electronic medical records: a qualitative case study of users' needs, expectations and realities.
abstract: Support is considered an important factor for realizing the benefits of health information technology (HIT) but there is a dearth of research on the topic of support, especially in primary care. We conducted a qualitative multiple case study of 4 family health teams (FHTs) and one family health organization (FHO) in Ontario, Canada in an attempt to gain insight into users' expectations and needs, and the realities of end-user support for primary care electronic medical records (EMRs). Data were collected by semi-structured interviews, documents review, and observation of training sessions. The analysis highlights the important role of on-site information technology (IT) staff and super-users in liaising with various stakeholders to solve technical problems and providing hardware and functional ('how to') support; the local development of data support practices to ensure consistent documentation; and the gaps that exist in users' and support personnel's understanding of each other's work processes.
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto. Faculty of Information, University of Toronto.
authors.forename: Aviv
authors.initials: A
authors.lastname: Shachak
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto.
authors.forename: Catherine
authors.initials: C
authors.lastname: Montgomery
authors.affiliation: Faculty of Information, University of Toronto.
authors.forename: Rustam
authors.initials: R
authors.lastname: Dow
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto.
authors.forename: Jan
authors.initials: J
authors.lastname: Barnsley
authors.affiliation: Institute for Clinical Evaluative Sciences. Department of Family and Community Medicine, University of Toronto. Toronto Western Hospital Family Health Team.
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
authors.affiliation: Centre for Global eHealth Innovation, University Health Network. Centre for Health, Wellness and Cancer Survivorship, University Health Network. Institute of Health Policy, Management and Evaluation, University of Toronto. Department of Anesthesia, University of Toronto. Dalla Lana School of Public Health, University of Toronto.
authors.forename: Alejandro R
authors.initials: AR
authors.lastname: Jadad
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto.
authors.forename: Louise
authors.initials: L
authors.lastname: Lemieux-Charles
keywords: Electronic medical record; End-user support; Family health teams; Qualitative research