title: Eliciting end-user expectations to guide the implementation process of a new electronic health record: A case study using concept mapping.
abstract: OBJECTIVE
  To evaluate the usability of concept mapping to elicit the expectations of healthcare professionals regarding the implementation of a new electronic health record (EHR). These expectations need to be taken into account during the implementation process to maximize the chance of success of the EHR.
  
  
  METHODS
  Two university hospitals in Amsterdam, The Netherlands, in the preparation phase of jointly implementing a new EHR. During this study the hospitals had different methods of documenting patient information (legacy EHR vs. paper-based records).
  
  
  METHODS
  Concept mapping was used to determine and classify the expectations of healthcare professionals regarding the implementation of a new EHR. A multidisciplinary group of 46 healthcare professionals from both university hospitals participated in this study. Expectations were elicited in focus groups, their relevance and feasibility were assessed through a web-questionnaire. Nonmetric multidimensional scaling and clustering methods were used to identify clusters of expectations.
  
  
  RESULTS
  We found nine clusters of expectations, each covering an important topic to enable the healthcare professionals to work properly with the new EHR once implemented: usability, data use and reuse, facility conditions, data registration, support, training, internal communication, patients, and collaboration. Average importance and feasibility of each of the clusters was high.
  
  
  CONCLUSIONS
  Concept mapping is an effective method to find topics that, according to healthcare professionals, are important to consider during the implementation of a new EHR. The method helps to combine the input of a large group of stakeholders at limited efforts.
authors.affiliation: Department of Medical Informatics, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. Electronic address: e.joukes@amc.uva.nl.
authors.forename: Erik
authors.initials: E
authors.lastname: Joukes
authors.affiliation: Department of Medical Informatics, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands; Department of Biomedical Engineering, Linköping University, SE-581 83 Linköping, Sweden. Electronic address: r.cornet@amc.uva.nl.
authors.forename: Ronald
authors.initials: R
authors.lastname: Cornet
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: mc.debruyne@vumc.nl.
authors.forename: Martine C
authors.initials: MC
authors.lastname: de Bruijne
authors.affiliation: Department of Medical Informatics, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. Electronic address: n.f.keizer@amc.uva.nl.
authors.forename: Nicolette F
authors.initials: NF
authors.lastname: de Keizer
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003142:Communication; D003625:Data Collection / Q000592:standards*; D057286:Electronic Health Records / Q000458:organization & administration* / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic
keywords: Concept mapping; Electronic health record; Expectation; Healthcare professional; Implementation