title: Implementing electronic records in NHS secondary care organizations in England: policy and progress since 1998.
abstract: A number of different policies have aimed to introduce electronic records into National Health Service (NHS) secondary care organizations in England over recent years. There has been little formal attempt to explore the overall impact of these policies (as opposed to evaluations of individual initiatives) and how they have developed and progressed over time.
  
  
  
  National NHS IT policy documents and evaluations of national NHS IT policy between 1998 and 2015.
  
  
  
  There has been limited progress in implementing integrated electronic records in secondary organizations since 1998.
  
  
  
  The management and execution of NHS IT policy has been poor, with over ambitious aims contributing to the limited success.
  
  
  
  Detailed guidance on how to implement electronic records in secondary care organizations is required. The ambitions of current policy should be revisited.
  
  
  
  Research exploring the costs and benefits of different approaches to introducing electronic records is needed.
authors.affiliation: York Trials Unit, Department of Health Sciences, University of York, York, YO10 5DD, UK.
authors.forename: Arabella
authors.initials: A
authors.lastname: Clarke
authors.affiliation: Department of Health Sciences, Faculty of Science, University of York, Area 4 Seebohm Rowntree Building, York, YO10 5DD, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Watt
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Sheard
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK.
authors.forename: John
authors.initials: J
authors.lastname: Wright
authors.affiliation: Department of Health Sciences, Faculty of Science, University of York, Area 4 Seebohm Rowntree Building, York, YO10 5DD, UK.|Institute of Health and Society, University of Newcastle, NE2 4AX, UK.
authors.forename: Joy
authors.initials: J
authors.lastname: Adamson
mesh_terms: D001291:Attitude of Health Personnel; D003284:Contract Services / Q000458:organization & administration; D003362:Cost-Benefit Analysis; D057286:Electronic Health Records / Q000458:organization & administration*; D004739:England; D006078:Government Programs / Q000191:economics / Q000458:organization & administration; D006284:Health Plan Implementation / Q000191:economics / Q000458:organization & administration*; D006291:Health Policy / Q000639:trends*; D006801:Humans; D063127:Secondary Health Care / Q000191:economics / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics / Q000458:organization & administration*
keywords: England; IT; NHS; electronic records; policy; secondary care