Brief review: Adoption of electronic medical records to enhance acute pain management
Abstract
Purpose The purpose of this paper is to examine physician barriers to adopting electronic medical records (EMRs) as well as anesthesiologists' experiences with the EMRs used by the acute pain management service at two tertiary care centres in Canada.Source We first review the recent literature to determine if physician barriers to adoption are changing given the exponential growth of information technology and the evolving healthcare environment. We next report on institutional experience from two academic health sciences centres regarding the challenges they encountered over the past ten years in developing and implementing an electronic medical record system for acute pain management.Principal findings The key identified barriers to adoption of EMRs are financial, technological, and time constraints. These barriers are identical to those reported in a systematic review performed prior to 2009 and remain significant factors challenging implementation. These challenges were encountered during our institution's process of adopting EMRs specific to acute pain management. In addition, our findings emphasize the importance of physician participation in the development and implementation stages of EMRs in order to incorporate their feedback and ensure the EMR system is in keeping with their workflow.Conclusions Use of EMRs will inevitably become the standard of care; however, many barriers persist to impede their implementation and adoption. These challenges to implementation can be facilitated by a corporate strategy for change that acknowledges the barriers and provides the resources for implementation. Adoption will facilitate benefits in communication, patient management, research, and improved patient safety.
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Access to ongoing support to use systems was important for system use and a barrier to implementation when lacking.
“Access to ongoing support to use systems was important for system use [21, 25, 28, 31, 37, 39, 43, 54] and a barrier to implementation when it was lacking [21].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [28]
Engagement of key stakeholders in the development and selection of e-health systems and in the planning and execution of implementation processes was important for implementation through fostering a sense of ownership, confidence, acceptance, enjoyment and self-pride towards the e-health system and increasing buy-in.
“Engagement of key stakeholders in the development and selection of e-health systems and in the planning and execution of implementation processes were important for implementation [16, 20, 28, 29, 34, 41, 44, 49–51, 53–56, 58] through fostering a sense of ownership [20, 44, 51], confidence [28], acceptance [34], enjoyment and self-pride [20] towards the e-health system and increasing buy-in [54].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [28]
Demographic factors such as age, education, sex, nationality, and clinical experience may influence healthcare professionals' attitudes towards e-health systems.
“Demographic factors such as age, education, sex, nationality, and clinical experience may influence healthcare professionals’ attitudes towards e-health systems [23, 28, 46, 56, 57];”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [28]
Cites
Apfelbaum, J. L., Chen, C., Mehta, S. S., & Gan, A. T. J. (2003) · Anesthesia & Analgesia · doi:10.1213/01.ane.0000068822.10113.9e · Cited by 2,207 · see citing works
The coming acceleration of global population ageing
Lutz, W., Sanderson, W. C., & Scherbov, S. (2008) · Nature · doi:10.1038/nature06516 · Cited by 1,442 · see citing works
International Association for the Study of Pain
Breivik, H. (2002) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(02)00465-7 · Cited by 1,222 · see citing works
International association for the study of pain
Cousins, M. J. (1989) · Pain · doi:10.1016/0304-3959(89)90017-1 · Cited by 1,200 · see citing works
Boonstra, A., & Broekhuis, M. (2010) · BMC Health Services Research · doi:10.1186/1472-6963-10-231 · Cited by 851 · see citing works
The prevalence of postoperative pain in a sample of 1490 surgical inpatients
Sommer, M., de Rijke, J. M., van Kleef, M., Kessels, A. G. H., Peters, M. L., Geurts, J. W. J. M., Gramke, H.-F., & Marcus, M. A. E. (2008) · European Journal of Anaesthesiology · doi:10.1017/s0265021507003031 · Cited by 471 · see citing works
The JBI model of evidence-based healthcare
Pearson, A., Wiechula, R., Court, A., & Lockwood, C. (2005) · International Journal of Evidence-Based Healthcare · doi:10.1111/j.1479-6988.2005.00026.x · Cited by 451 · see citing works
Schoen, C., Osborn, R., Squires, D. A., Doty, M. M., Rasmussen, P. W., Pierson, R., & Applebaum, S. (2012) · Health Affairs · doi:10.1377/hlthaff.2012.0884 · Cited by 286 · see citing works
Forsythe, M. E., Dunbar, M., Hennigar, A. W., Sullivan, M. J. L., & Gross, M. (2008) · Pain Research and Management · doi:10.1155/2008/730951 · Cited by 278 · see citing works
Harden, N. R., Bruehl, S. P., Stanos, S. P., Brander, V. A., Chung, O. Y., Saltz, S., Adams, A., & Stulberg, D. S. (2003) · Pain · doi:10.1016/j.pain.2003.08.009 · Cited by 221 · see citing works
Holden, R. J. (2010) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2009.12.003 · Cited by 162 · see citing works
Medical and psychological comorbidity predicts poor pain outcomes after total knee arthroplasty
Singh, J. A., & Lewallen, D. G. (2013) · Lara D. Veeken · doi:10.1093/rheumatology/kes402 · Cited by 151 · see citing works
Junglas, I. A., Abraham, C., & Ives, B. (2008) · Decision Support Systems · doi:10.1016/j.dss.2008.11.012 · Cited by 119 · see citing works
Perioperative Care for the Older Outpatient Undergoing Ambulatory Surgery
White, P. F., White, L. M., Monk, T. G., Jakobsson, J., Raeder, J. C., Mulroy, M. F., Bertini, L., Torri, G., Solca, M., Pittoni, G. M., et al. (2012) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e31824f19b8 · Cited by 107 · see citing works
A survey of acute pain services in Germany and a discussion of international survey data☆
Stamer, U. M., Mpasios, N., ST, F., et al. (2002) · Regional Anesthesia & Pain Medicine · doi:10.1053/rapm.2002.29258 · Cited by 104 · see citing works
Holden, R. J. (2011) · Journal of Patient Safety · doi:10.1097/pts.0b013e3182388cfa · Cited by 95 · see citing works
Adoption of Anesthesia Information Management Systems by Academic Departments in the United States
Halbeis, C. B. E., Epstein, R. H., Macario, A., et al. (2008) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e31818322d2 · Cited by 95 · see citing works
Genome-Wide Association Study of Acute Post-Surgical Pain In humans
Kim, H., Ramsay, E. S., Lee, H., Wahl, S. M., & Dionne, R. A. (2009) · Pharmacogenomics · doi:10.2217/14622416.10.2.171 · Cited by 68 · see citing works
VanDenKerkhof, E. G., Goldstein, D. H., Lane, J., et al. (2003) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/bf03021034 · Cited by 64 · see citing works
Self-citationPediatricians’ Use of Health Information Technology: A National Survey
Leu, M. G., O’Connor, K. G., Marshall, R., et al. (2012) · PEDIATRICS · doi:10.1542/peds.2012-0396 · Cited by 58 · see citing works
A Survey of Acute Pain Service Structure and Function in United States Hospitals
Nasir, D., Howard, J. E., Joshi, G. P., & Hill, G. E. (2011) · Pain Research and Treatment · doi:10.1155/2011/934932 · Cited by 57 · see citing works
Holden, R. J. (2011) · Theoretical Issues in Ergonomics Science · doi:10.1080/1463922x.2010.549249 · Cited by 56 · see citing works
“Why the Hell Do We Need Electronic Health Records?”
Hoerbst, A., Ammenwerth, E., & Hackl, W. O. (2010) · Methods of Information in Medicine · doi:10.3414/me10-02-0020 · Cited by 55 · see citing works
Bramble, J. D., Galt, K. A., Siracuse, M. V., Abbott, A. A., Drincic, A., Paschal, K. A., & Fuji, K. T. (2010) · Health Care Management Review · doi:10.1097/hmr.0b013e3181c3f9ad · Cited by 53 · see citing works
Holanda, A. A., Sá, H. L. D. C. E., Vieira, A. P. G. F., & Catrib, A. M. F. (2011) · Journal of Medical Systems · doi:10.1007/s10916-011-9801-3 · Cited by 43 · see citing works
Imminent adopters of electronic health records in ambulatory care
Kaushal, R., Bates, D. W., Jenter, C. A., Mills, S., Volk, L. A., Burdick, E., Tripathi, M., & Simon, S. R. (2009) · Journal of Innovation in Health Informatics · doi:10.14236/jhi.v17i1.709 · Cited by 41 · see citing works
Implementation of electronic medical records: theory-informed qualitative study.
Greiver, M., Barnsley, J., Glazier, R. H., Moineddin, R., & Harvey, B. J. (2011) · Europe PMC (PubMed Central) · Cited by 39 · see citing works
Adoption of anesthesia information management systems by US anesthesiologists
Trentman, T. L., Mueller, J. T., Ruskin, K. J., Noble, B. N., & Doyle, C. A. (2011) · Journal of Clinical Monitoring and Computing · doi:10.1007/s10877-011-9289-x · Cited by 38 · see citing works
Katz, J., Buis, T., & Cohen, L. (2008) · Canadian Journal of Anesthesia/Journal canadien d'anesthésie · doi:10.1007/bf03016320 · Cited by 37 · see citing works
Anatomy of an Anesthesia Information Management System
Shah, N. J., Tremper, K. K., & Kheterpal, S. (2011) · Anesthesiology Clinics · doi:10.1016/j.anclin.2011.05.013 · Cited by 36 · see citing works
Acute pain management services have progressed, albeit insufficiently in Canadian academic hospitals
Goldstein, D. H., VanDenKerkhof, E. G., & Blaine, W. C. (2004) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/bf03019101 · Cited by 35 · see citing works
Self-citationBeyond the Focus Group: Understanding Physicians’ Barriers to Electronic Medical Records
Yan, H., Gardner, R. L., & Baier, R. R. (2012) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(12)38024-0 · Cited by 34 · see citing works
Trends in adoption of electronic health records by family physicians in Washington State
Stream, G. (2009) · Journal of Innovation in Health Informatics · doi:10.14236/jhi.v17i3.729 · Cited by 29 · see citing works
Peterson, L. T., Ford, E. W., Eberhardt, J. S., Huerta, T. R., & Menachemi, N. (2009) · Journal of Medical Systems · doi:10.1007/s10916-009-9352-z · Cited by 29 · see citing works
Effken, J. A., Gephart, S. M., Brewer, B. B., & Carley, K. M. (2012) · CIN Computers Informatics Nursing · doi:10.1097/nxn.0b013e3182701082 · Cited by 29 · see citing works
Goldstein, D. H., Ellis, J., Brown, R., Wilson, R. A., Penning, J. P., Chisom, K., VanDenKerkhof, E. G., & Initiative, M. O. T. C. C. A. P. (2004) · Pain Research and Management · doi:10.1155/2004/397452 · Cited by 27 · see citing works
Self-citationGoldstein, D. H., VanDenKerkhof, E. G., & Rimmer, M. J. (2002) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/bf03017457 · Cited by 24 · see citing works
Self-citationUtilisation of information technologies in ambulatory care in Switzerland
Brunner, L. (2010) · Swiss Medical Weekly · doi:10.4414/smw.2010.13088 · Cited by 22 · see citing works
How Do Patients Perceive Electronic Documentation at the Bedside?
Dagnone, V., Wilson, R., Goldstein, D., Murdoch, J., Rimmer, M. J., & VanDenKerkhof, E. (2006) · Journal for Healthcare Quality · doi:10.1111/j.1945-1474.2006.tb00619.x · Cited by 21 · see citing works
Self-citationBalust, J., Halbeis, C. B. E., & Macario, A. (2010) · European Journal of Anaesthesiology · doi:10.1097/eja.0b013e3283313fc2 · Cited by 20 · see citing works
Integration of the Enterprise Electronic Health Record and Anesthesia Information Management Systems
Springman, S. R. (2011) · Anesthesiology Clinics · doi:10.1016/j.anclin.2011.05.007 · Cited by 16 · see citing works
A survey of acute pain services in teaching hospitals in the Republic of Ireland
Hu, P., Owens, T. J., & Harmon, D. C. (2007) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-007-0037-7 · Cited by 13 · see citing works
Shortcomings and Challenges of Information System Adoption
Vigoda, M. M., Rothman, B. S., & Green, J. A. (2011) · Anesthesiology Clinics · doi:10.1016/j.anclin.2011.05.010 · Cited by 12 · see citing works
VanDenKerkhof, E. G., Goldstein, D. H., Rimmer, M. J., et al. (2004) · Acute Pain · doi:10.1016/j.acpain.2004.07.001 · Cited by 12 · see citing works
Self-citationElectronic Monitoring in an Acute Pain Management Service
Goldstein, D. H., Wilson, R. A., & VanDenKerkhof, E. G. (2007) · Pain Medicine · doi:10.1111/j.1526-4637.2007.00373.x · Cited by 10 · see citing works
Self-citationRichardson, J. E., Abramson, E. L., Pfoh, E. R., & Kaushal, R. (2011) · PubMed Central · Cited by 5 · see citing works
Gocsik, T. (2012) · PubMed · Cited by 3 · see citing works
(2009) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-009-9235-2 · Cited by 3 · see citing works
Baird, P. (2013) · Biomedical Instrumentation & Technology · doi:10.2345/0899-8205-47.2.180 · Cited by 1 · see citing works
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Ross, J., Stevenson, F., Lau, R., & Murray, E. (2016) · Implementation Science · doi:10.1186/s13012-016-0510-7 · Cited by 1,011 · see citing works
van den Wijngaart, L. S., Geense, W. W., Boehmer, A. L., Brouwer, M. L., Hugen, C. A., van Ewijk, B. E., Koenen-Jacobs, M.-J., Landstra, A. M., Niers, L. E., van Onzenoort-Bokken, L., et al. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9245 · Cited by 30 · see citing works
- Authors
- Goldstein, D. H., Phelan, R., Wilson, R., Ross-White, A., VanDenKerkhof, E. G., Penning, J. P., & Jaeger, M.
- Affiliations
- Queen's University (CA)
- Ottawa Hospital (CA)
- Corresponding author
- Jaeger, Melanie
- Venue
- Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Published
- 2013-11-14
- Volume
- 61
- Issue
- 2
- Pages
- 164-179
- ISSN
- 0832-610X (ISSN-L)
- 1496-8975
- OpenAlex
- W125281953
- Cited by
- 24
- References
- 49
- Citations by year
- 2025: 1 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 6 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 1 · 2013: 1
- FWCI
- 3.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
- PubMed (publishedVersion)
- QSpace (Queen's University Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
- Keywords
- electronic health records, acute pain management, anesthesiologists, clinical workflow, EMR implementation, patient safety, academic medical centers
- MeSH terms
- Anesthesiology, Canada, Diffusion of Innovation, Humans, Physicians, Workflow, Electronic Health Records, Acute Pain, Tertiary Care Centers
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