The DOI matches its Crossref record; 56 of the 57 references it cites were found in a registry or an index.
Adopting electronic medical records in primary care: Lessons learned from health information systems implementation experience in seven countries
Abstract
The adoption of health information systems is seen world wide as one method to mitigate the widening health care demand and supply gap. The purpose of this review was to identify the current state of knowledge about health information systems adoption in primary care. The goal was to understand factors and influencers affecting implementation outcomes from previous health information systems implementations experiences. A comprehensive systematic literature review of peer reviewed and grey literature was undertaken to identify the current state of knowledge regarding the implementation of health information systems. A total of 6 databases, 27 journal websites, 20 websites from grey sources, 9 websites from medical colleges and professional associations as well as 22 government/commission websites were searched. The searches returned almost 3700 article titles. Eighty-six articles met our inclusion and exclusion criteria. Articles show that systems' graphical user interface design quality, feature functionality, project management, procurement and users' previous experience affect implementation outcomes. Implementers had concerns about factors such as privacy, patient safety, provider/patient relations, staff anxiety, time factors, quality of care, finances, efficiency, and liability. The review showed that implementers can insulate the project from such concerns by establishing strong leadership, using project management techniques, establishing standards and training their staff to ensure such risks do not compromise implementation success. The review revealed the concept of socio-technical factors, or "fit" factors, that complicate health information systems deployment. The socio-technical perspective considers how the technical features of a health information system interact with the social features of a health care work environment. The review showed that quality of care, patient safety and provider/patient relations were not, positively or negatively, affected by systems implementation. The fact that no articles were found reviewing the benefits or drawbacks of health information systems accruing to patients should be concern to adopters, payers and jurisdictions. No studies were found that compared how provider-patient interactions in interviews are effected when providers used electronic health information systems as opposed to the paper equivalent. Very little information was available about privacy and liability.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“A team-based partnership approach, collaborative efforts and good coordination between stakeholders and organisations were all shown to be important for implementation [34, 41, 55, 77].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [77]
In the citing paper
“Non-clinical staff often had better knowledge of optimising processes compared to clinicians [77]”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [77]
In the citing paper
“different members of the workforce brought different perspectives and skills to the implementation [77].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [77]
In the citing paper
“patient values and preferences [3, 33] and concerns about clinician-patient relationships [42, 77] impeded implementation”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [77]
In the citing paper
“Resistance to change caused by disagreement with the evidence, negative beliefs about the usefulness or added value of the intervention or belief that the intervention was not part of their role were commonly described as a barrier to implementation [3, 14, 35, 41, 67–70, 76, 77, 80].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [77]
In the citing paper
“Previous personal experience in clinical practice or with the information system affected professional attitudes to a new system or intervention [54, 66, 77, 81].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [77]
In the citing paper
“Effective project management (e.g. using an incremental approach over time according to a strategic plan allowing a transition period between old and new system) was shown to facilitate implementation [77].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [77]
In the citing paper
“Incentives by government organisations and other external stakeholders may facilitate adoption by healthcare organisations [17, 18, 39, 48, 49].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [39]
In the citing paper
“Financial incentives include the provision of initial funds to cover upfront costs [49], financial sponsorship [39], reimbursements for adoption [19, 30, 31, 36], and pay-for-performance initiatives [24, 36, 37, 49].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [39]
In the citing paper
“Providing a period of transition in which end users can become familiar with and learn how to use new systems has been advocated [39, 50].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [39]
In the citing paper
“Incremental implementation strategies where features are made available to users according to a plan were cited as preferable to ‘big bang’ approaches to implementation within complex organisations [39, 49].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [39]
In the citing paper
“Our study was UK-based, although the challenge of implementing effective decision support for prescribing, and specifically the problem of alert fatigue, is international.12 24 50”
From ‘Too much, too late’: mixed methods multi-channel video recording study of computerized decision support systems and GP prescribing (2013) · cites this paper as [50]
In the citing paper
“Difficulties in eHealth implementation are international phenomena, with similar problems being widely reported [102-105].”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [105]
Citations
Cites
1 retracted
Nursing record systems: effects on nursing practice and healthcare outcomes.
Urquhart, C., Currell, R., Grant, M., & Hardiker, N. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002099.pub2 · Cited by 246
RetractedPharmacological interventions for somatoform disorders in adults
Kleinstäuber, M., Witthöft, M., Steffanowski, A., van Marwijk, H., Hiller, W., & Lambert, M. J. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010628.pub2 · Cited by 11,369
Garg, A. X., Adhikari, N. K. J., McDonald, H., Rosas-Arellano, M. P., Devereaux, P. J., Beyene, J., Sam, J., & Haynes, R. B. (2005) · JAMA · doi:10.1001/jama.293.10.1223 · Cited by 2,936
Role of Computerized Physician Order Entry Systems in Facilitating Medication Errors
Koppel, R. (2005) · JAMA · doi:10.1001/jama.293.10.1197 · Cited by 2,126
Safar, P. J., & Grenvik, A. N. A. (1971) · CHEST Journal · doi:10.1378/chest.59.5.535 · Cited by 1,995
Ash, J. S. (2003) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1471 · Cited by 1,789
Han, Y. Y., Carcillo, J. A., Venkataraman, S. T., Clark, R. S. B., Watson, R. S., Nguyen, T. C., Bayir, H., & Orr, R. A. (2005) · Pediatrics · doi:10.1542/peds.2005-1287 · Cited by 1,149
Kh, S., & Friedemann, H. (1991) · PubMed · Cited by 462
Computer Technology and Clinical Work: Still Waiting for Godot
Wears, R. L., & Berg, M. (2005) · JAMA · doi:10.1001/jama.293.10.1261 · Cited by 448
Electronic Health Record Use and the Quality of Ambulatory Care in the United States
Linder, J. A., Ma, J., Bates, D. W., Middleton, B., & Stafford, R. S. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.13.1400 · Cited by 438
Flagged first, then by citations
1 of the 57 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Items 301–400 of 666
Dutch Electronic Medical Record - Complexity Perspective
Barjis, J. (2010) · Hawaii International Conference on System Sciences (HICSS) · doi:10.1109/hicss.2010.162 · Cited by 9
“There are also concerns over privacy, patient safety, provider/patient relations, staff anxiety, time needed to implement, quality of care, financial, efficiency, and liability [4].”
BackgroundInfluentialWallace, S., Maxey, K., & Iyer, L. S. (2014) · Journal of Information Technology Case and Application Research · doi:10.1080/15228053.2014.912478 · Cited by 11
Success factors for health information system development
Sensuse, D. I., Kareen, P., Noprisson, H., & Pratama, M. O. (2017) · International Conference on Information Technology Systems and Innovation · doi:10.1109/icitsi.2017.8267936 · Cited by 9
Almutairi, B. A. M. (2011) · UCL Discovery (University College London) · Cited by 9
Electronic Health Record Acceptance by Physicians: A Single Hospital Experience in Daily Practice
Pavlović, A., Rajović, N., Stojanovic, J. P., Akinyombo, D., Ugljesic, M., Pavlica, M., Pavlovic, V. R., Randjelovic, S., Spaić, D., Mašić, S., et al. (2021) · BioMedInformatics · doi:10.3390/biomedinformatics1010002 · Cited by 11
Distributed IT championing: A process theory
Negoita, B., Rahrovani, Y., Lapointe, L., & Pinsonneault, A. (2021) · Journal of Information Technology · doi:10.1177/02683962211019406 · Cited by 10
“…role of multiple instantiations of championing behaviors to the success of IT implementations in hospitals (Boonstra and Broekhuis, 2010; Gruber et al., 2009; Ludwick and Doucette, 2009), the health domain was deemed an appropriate and revealing context for this study (Chiasson and Davidson, 2005).”
BackgroundStaff perceptions of the implementation of a trauma video review program at a level I trauma center
Dainty, K. N., Seaton, M. B., McGowan, M., & Nolan, B. (2021) · AEM Education and Training · doi:10.1002/aet2.10714 · Cited by 8
Measuring EMR Adoption: A Framework and Case Study
Price, M., Lau, F., & Lai, J. (2011) · ElectronicHealthcare · Cited by 8
Exploring the success factors of Electronic Health Record systems adoption
Kök, O. M., Başoğlu, N., & Daim, T. U. (2011) · Portland International Conference on Management of Engineering and Technology (PICMET) · Cited by 8
Implementing a National Electronic Referral Program: Qualitative Study
McGovern, M., Quinlan, M., Doyle, G., Moore, G., & Geiger, S. (2018) · JMIR Medical Informatics · doi:10.2196/10488 · Cited by 8
“A sociotechnical approach considers how the technical features of a health information system interact with the social features of a health care work environment [12].”
BackgroundSchuetze, L., Srivastava, S., Kuunibe, N., Rwezaula, E. J., Missenye, A. M., Stoermer, M., & Allegri, M. D. (2023) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2023.6896 · Cited by 10
“The number of verified and expected claims differed between regions, with the median (IQR) number of verified claims ranging from 5 (0-31) in Dodoma to 27 (3-51) in Shinyanga, and the median (IQR) number of expected claims ranging from 34 (13.”
Lapão, L. V. (2015) · Israel Journal of Health Policy Research · doi:10.1186/s13584-015-0036-5 · Cited by 8
“Other well-known aspects are the socio-technical factors, or “ fit ” factors, that complicate the design and deployment of health information systems [7].”
BackgroundA user satisfaction study of the NHS Online Prescription Prepayment Certificate
Zahir Irani, A., Weerakkody, V., Molnar, A., Lee, H., Hindi, N. M., & Osman, I. H. (2014) · Health Policy and Technology · doi:10.1016/j.hlpt.2014.05.003 · Cited by 8
“Electronic healthcare (e-health), defined as “the combined use of electronic communication and information technology in the health sector” [2], is aimed at improving the quality of healthcare [3], reducing its cost [4] and in the same time addressing the health demand supply gap [5].”
BackgroundHealth information technology performance measures: a lifecycle analysis
Koong, K. S., Flores, J., Sun, J., & Liu, L. C. (2011) · International Journal of Services and Standards · doi:10.1504/ijss.2011.045048 · Cited by 8
“HIT can help bridge the widening gap between the demand for healthcare services and the supply (Ludwick and Doucette, 2009).”
BackgroundMostert-Phipps, N., Pottas, D., & Korpela, M. J. (2013) · South African Family Practice · doi:10.1080/20786204.2013.10874415 · Cited by 8
Gavurová, B., Balloni, A. J., Tarhaničová, M., & Kováč, V. (2018) · Economies · doi:10.3390/economies6030047 · Cited by 10
Breebaart, H., & Groenou, M. I. B. V. (2018) · JMIR Aging · doi:10.2196/10697 · Cited by 8
“Most studies are only dealing with theoretical models of technology acceptance [5,6].”
To follow the yellow brick road: exploring the journey to mental well-being consumption
Wyllie, J., & Carlson, J. (2018) · Journal of Marketing Management · doi:10.1080/0267257x.2018.1556224 · Cited by 8
“Although this service quality dimension is most prominent in the field of electronic health service care literature (c.f. Akter, D’Amber, & Ray, 2013; Ludwick & Doucette, 2007), the interviewees consistently stressed privacy concerns in relation to the use and storage of their personal health…”
BackgroundDecision Support System to Diagnosis and Classification of Epilepsy in Children
Silva, C., Gonçalves, D., Pereira, L. A. M., Agostinho, M., & Rijo, R. (2020) · Zenodo (CERN European Organization for Nuclear Research) · doi:10.3217/jucs-020-06-0907 · Cited by 8
Alzghaibi, H. (2019) · doi:10.23889/suthesis.52386 · Cited by 7
Nortey, E. N. N., Adjei-Twum, A., Okyere-Kwakye, E., & Alhassan, T. (2025) · Property Management · doi:10.1108/pm-06-2024-0063 · Cited by 7
Meaningful use and meaningful curricula: a survey of health informatics programmes in the USA
Koong, K. S., Ngafeeson, M. N., & Liu, L. C. (2012) · International Journal of Electronic Healthcare · doi:10.1504/ijeh.2012.048666 · Cited by 7
“Some researchers have investigated the adoption of EHRs and have enumerated barriers to their adoption and implementation (Ford et al., 2006; Ludwick and Doucette, 2009).”
BackgroundFormative Evaluation of the Implementation of eHealth in the Philippines: A Qualitative Study
Evio, B. D., & Bonito, S. R. (2024) · Acta Medica Philippina · doi:10.47895/amp.v58i12.9289 · Cited by 7
“19,20 As in any organizational change process, those involved within and outside the organization need to undergo a period of transition to allow for preparation and acceptance to ensure correct implementation and long-term commitment.”
BackgroundExpanding the boundaries of clinical informatics for interdisciplinary systems research
King, N. E. (2014) · Health Systems · doi:10.1057/hs.2013.18 · Cited by 7
“Ludwick & Doucette (2009) report a dearth of literature that looks at the bene fi ts or drawbacks of health IS accruing to patients even though such considerations should be of concern to adopters, payers, and jurisdictions.”
BackgroundHörhammer, I., Kujala, S., Hilama, P., & Heponiemi, T. (2021) · Journal of Medical Internet Research · doi:10.2196/28976 · Cited by 6
“Such practices include proper informing of the new services before implementation [15,32], engagement of the personnel in planning [15], adequate training [19-21], and enough time for learning [18].”
Beyond Privacy: Benefits and Burdens of E-Health Technologies in Primary Care
Aultman, J. M., & Dean, E. A. (2014) · The Journal of Clinical Ethics · doi:10.1086/jce201425108 · Cited by 7
A hierarchical decision model (HDM) for exploring the adoption of electronic health records
Mudavadi, C., Hogaboam, L., & Daim, T. U. (2016) · Portland International Conference on Management of Engineering and Technology (PICMET) · doi:10.1109/picmet.2016.7806627 · Cited by 7
Adopting electronic medical records
Price, M., Singer, A. G., & Kim, J. (2013) · Canadian Family Physician · Cited by 7
Simon, A. (2020) · Health Informatics Journal · doi:10.1177/1460458219895910 · Cited by 7
“Previous publications on the subject focused mainly on individual projects and specific healthcare IS, 10,12–18 were conducted in specific use contexts, 11,14,19–23 involved rather small numbers of participants or dealt with a single health profession (i.e. only physicians or leading staff members).”
BackgroundFarrag, E. H. M., Ahmed, B. N., & Hashish, E. A. A. (2020) · Journal of Nursing and Practice · doi:10.36959/545/373 · Cited by 7
Faktor-faktor yang mempengaruhi keberhasilan implementasi simpus di puskesmas kabupaten sragen
Rahmawati, M. D., & Nugroho, E. (2020) · Journal of Information Systems for Public Health · doi:10.22146/jisph.33146 · Cited by 7
Syed-Mohamad, S.-M., Ali, S. H., & Mat-Husin, M. N. (2010) · Health Information Management Journal · doi:10.1177/183335831003900105 · Cited by 7
“As Ludwick and Doucette (2009) have demonstrated, by eliminating data duplication and redundancies, EPRs can help avoid inappropriate action taken by caregiver.”
BackgroundResident-Initiated Interventions to Improve Inpatient Heart Failure Management
Oujiri, J., Hakeem, A., Pack, Q. R., Holland, R., Meyers, D. S., Hildebrand, C. J., Bridges, A. J., Roach, M., & Vogelman, B. (2011) · BMJ Quality … Safety · doi:10.1136/bmjqs.2009.039339 · Cited by 7
A Synergistic Bridge Between Human–Computer Interaction and Data Management Within CDSS
Azadi, A., & García‐Peñalvo, F. J. (2025) · Data · doi:10.3390/data10050060 · Cited by 6
Adopting DevOps practices: an enhanced unified theory of acceptance and use of technology framework
Salih, A. M., Syed-Mohamad, S. M., Keikhosrokiani, P., & Samsudin, N. H. (2023) · International Journal of Power Electronics and Drive Systems/International Journal of Electrical and Computer Engineering · doi:10.11591/ijece.v13i6.pp6701-6717 · Cited by 7
“Moreover, lack of training may increase the practitioners’ ambiguity and unfamiliarity with DevOps practices implementation, leading to failure of DevOps implementation [83].”
Mussi, C. C., Luz, R., Damázio, D. D. R., dos Santos, E. M., Sun, V., Porto, B. S. D. S., Parma, G. O. C., Cordioli, L. A., Birch, R. S., & Guerra, J. B. S. O. D. A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20216971 · Cited by 6
“It must be considered that the success of a large-scale IT implementation program does not depend only on actions at the national level, but on a set of local aspects linked to each HU [7,28].”
BackgroundInfluentialThe electronic medical record and patient-centered care
Nusbaum, N. J. (2011) · Online Journal of Public Health Informatics · doi:10.5210/ojphi.v3i2.3721 · Cited by 6
“[2] Clinicians wish to implement the EMR in such a way that it does not retard the emotional depth of the interaction between the physician and patient.”
BackgroundPerspectives of New Zealand patients and GPs at the beginning of patient portal implementation
Wells, S. J., Mahony, F., Huang, Y., & Day, K. (2019) · Journal of Primary Health Care · doi:10.1071/hc19016 · Cited by 7
Representation Learning for Electronic Health Records: A Survey
Chen, P. (2020) · Journal of Physics Conference Series · doi:10.1088/1742-6596/1487/1/012015 · Cited by 6
A case study of user assessment of a corrections electronic health record.
Madison, L. G., & Phillip, W. R. (2011) · PubMed Central · Cited by 6
Lettieri, E., Radaelli, G., & Masella, C. (2010) · International Journal of Information Systems and Change Management · doi:10.1504/ijiscm.2010.033077 · Cited by 6
“Hospital managers can introduce mandatory interventions, tailored incentive or sanction programmes, communication strategies, feedback mechanisms, rituals of transition, local champions etc. (e.g., Ludwick and Doucette, 2009; Stutman et al., 2007; Lorenzi and Riley, 2000).”
BackgroundA JOURNEY INTO THE HIDDEN LIVES OF ELECTRONIC MEDICAL RECORDS (EMRS): ACTION RESEARCH IN THE MAKING
Boulus-Rødje, N. (2010) · Summit (Simon Fraser University) · Cited by 6
Marcela, M., Analía, B., Ana, M. G. S., Gómez, A., Luna, D. R., & Fernán, G. B. D. Q. (2013) · Studies in health technology and informatics · doi:10.3233/978-1-61499-289-9-1171 · Cited by 6
Information technology and diffusion in the New Zealand public health sector
Nath, N. D., Hu, Y., & Budge, C. (2016) · Qualitative Research in Accounting & Management · doi:10.1108/qram-02-2015-0026 · Cited by 6
Realizing the Value of EHR Systems Critical Success Factors
Regan, E. A., & Wang, J. (2016) · International Journal of Healthcare Information Systems and Informatics · doi:10.4018/ijhisi.2016070101 · Cited by 7
Gopalakrishna‐Remani, V., Brown, J. R., Shanker, M. S., & Hu, M. (2017) · Information & Management · doi:10.1016/j.im.2017.05.007 · Cited by 6
Chabot, C., Gilbert, M., Haag, D., Ogilvie, G. S., Hawe, P., Bungay, V., & Shoveller, J. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-2871-x · Cited by 6
Electronic Medical Records in Primary Care: Are we there yet?
Grewal, G. S. (2014) · UBC Faculty of Medicine medical journal · Cited by 6
Franz, B. A., & Murphy, J. W. (2015) · Perspectives in biology and medicine · doi:10.1353/pbm.2015.0029 · Cited by 6
“…physicians, however, is that the use of electronic medical records might be a barrier to communication between patients and health professionals (Ludwick and Doucette 2009; Ludwick, Manca, and Doucette 2010 For example, the amount of time interacting with electronic devices and staring at a…”
BackgroundVatnøy, T. K., Vabo, G. L., & Fossum, M. (2014) · Lecture notes in computer science · doi:10.1007/978-3-319-07293-7_67 · Cited by 6
“The GUI of the systems, design quality, feature functionality as well as project management, procurement, users’ and the end users’ previous experience are factors of importance [14].”
BackgroundResultInfluentialUsing text mining to diagnose and classify epilepsy in children
Pereira, L. A. M., Rijo, R., Silva, C., & Agostinho, M. (2013) · IEEE International Conference on e-Health Networking, Applications and Services (Healthcom) · doi:10.1109/healthcom.2013.6720698 · Cited by 6
“Electronic medical records (EMR) include patient demographics, summaries, medical history and lab tests, which are important for physicians to know the needs and take care of patients [8].”
BackgroundSubstance Abuse Treatment Programs’ Data Management Capacity: an Exploratory Study
Wisdom, J. P., Ford, J. H., Wise, M. E., Mackey, D., & Green, C. A. (2010) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-010-9221-z · Cited by 6
“, computerized physician order entry, electronic medical records) across hospitals and ambulatory care organizations in seven countries identified implementation risk factors that included staff anxiety and resistance to changing long-established processes, concerns about affecting provider– patient relationships, as…”
BackgroundCultivating and Sharing Tacit Knowledge in the Medical Field
Ghabban, M. (2024) · International Journal of Knowledge-Based Organizations · doi:10.4018/ijkbo.347917 · Cited by 5
“Specific challenges related to patient confidentiality significantly decrease the likelihood of observing no change in patient care quality compared to significant improvement (coefficient = −2.963), suggesting potential legal or ethical implications (Ludwick & Doucette, 2009).”
Influentialrelevance of public knowledge and the degree of health
Sjahruddin, H., Nugroho, B. S., Sembiring, T. B., Bangkara, B. M. A. S. A., & Fatmawati, E. (2022) · International Journal of Health Sciences · doi:10.53730/ijhs.v6n1.4978 · Cited by 5
Implementation, Adoption and Use of the Kanta Services in Finland 2010–2022
Jormanainen, V. J., Vehko, T., Lindgren, M., Keskimäki, I., & Kaila, M. (2023) · Studies in health technology and informatics · doi:10.3233/shti230108 · Cited by 5
“Internationally a prevailing solution offered for these challenges is to deploy large-scale information and communication technology systems [1,2].”
BackgroundBaines, S., Hill, P., & Garrety, K. (2014) · Social Policy and Society · doi:10.1017/s1474746414000256 · Cited by 5
“…contrast to the extensive literature available concerning the implementation of electronic records in the health sector (Hartswood et al., 2003; Gans et al., 2005; Ludwick and Doucette, 2009), and the closely scrutinised progress of the NHS’s national programme (Hendy et al., 2005; Coiera, 2007).”
BackgroundQuimbaya, A. P., González, R. A., Muñoz, O., García, O., & Bohórquez, W. (2017) · Ingenieria y Universidad · doi:10.11144/javeriana.iyu22-1.spem · Cited by 4
“This goal is motivated by the increasing adoption of health information systems in primary care, which has produced millions of electronic medical records EMRs all over the world [1].”
BackgroundLotfi, F. H., & Soleimani, A. (2020) · International Conference on Computation, Automation and Knowledge Management (ICCAKM) · doi:10.1109/iccakm46823.2020.9051518 · Cited by 5
“Unfortunately, the rapid growth of information technology advancements and the like, do not always allow the growth and adoption of healthcare systems to be fully embraced by end-users, the patients themselves, their families and caregivers [1].”
BackgroundMalm-Nicolaisen, K., Fagerlund, A. J., & Pedersen, R. (2022) · Studies in health technology and informatics · doi:10.3233/shti220195 · Cited by 6
Primary Care Informatics: Vitalizing the Bedrock of Health Care
You, J. G.-T., Leung, T. I., Pandita, D., & Sakumoto, M. (2024) · Journal of Medical Internet Research · doi:10.2196/60081 · Cited by 6
MacPherson, E., Dhaliwal, C., & Richardson, J. A. (2014) · Current Geriatrics Reports · doi:10.1007/s13670-014-0094-5 · Cited by 5
Investigating usability and "meaningful use" of electronic medical records
Teston, C. B. (2012) · ACM International Conference on Design of Communication (SIGDOC) · doi:10.1145/2379057.2379101 · Cited by 5
A Kinect-based 3D hand-gesture interface for 3D databases
Herrera-Acuña, R. A., Argyriou, V., & Velastín, S. A. (2014) · Journal on Multimodal User Interfaces · doi:10.1007/s12193-014-0173-0 · Cited by 5
“As a result, important parameters for the diagnosis of diseases can be estimated, allowing a more efficient control of the demanding health services, especially for primary care [38].”
BackgroundInternational Medical Graduates and Health Information Technology Use in the United States
Mazurenko, O., Gupte, G., & Yeager, V. A. (2012) · Advances in health care management · doi:10.1108/s1474-8231(2012)0000012010 · Cited by 5
Analysis of Resource Intensive Activity Volumes in us Hospitals
Boodhoo, S., & Das, S. K. (2016) · John Wiley & Sons, Inc. eBooks · doi:10.1002/9781118919408.ch12 · Cited by 5
Barriers in New Health and Social Care Technology Implementation in the United Kingdom, a Case Study
Blanchard, A., Prior, F., Barton, J. C., & Dawson, T. (2016) · International Conference on Developments in eSystems Engineering (DeSE) · doi:10.1109/dese.2016.13 · Cited by 5
“This can help to break down initial barriers, particularly relating to resistance to change [5].”
BackgroundMethodInfluentialFeasibility of eHealth Implementation in India Learning from Global Experience
Sharma, R. K., & Prashar, R. (2006) · Asia Pacific Journal of Health Management · doi:10.24083/apjhm.v14i3.297 · Cited by 5
Schiza, E. C., Foka, M., Stylianides, N., Kyprianou, T., & Schizas, C. N. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-813144-2.00011-8 · Cited by 5
Clinical Evaluation of Oral Diseases
Idahosa, C. N., & Kerr, A. R. (2019) · Springer eBooks · doi:10.1007/978-3-319-72303-7_3 · Cited by 5
Huang, X., Wilkie, R., Mamas, M. A., & Yu, D. (2021) · Journal of Diabetes and Clinical Research · doi:10.33696/diabetes.3.042 · Cited by 6
Organizational Dynamics of Sustainable eHealth Implementation: A Case Study of eHMIS
Fanta, G. B., Pretorius, L., & Erasmus, L. D. (2017) · Portland International Conference on Management of Engineering and Technology (PICMET) · doi:10.23919/picmet.2017.8125472 · Cited by 5
“The proper execution of key processes of eHealth implementation such as stakeholders engagement, change management, project management, data management, training and communications are key elements of success in the course of eHealth implementation [6], [8].”
BackgroundInfluentialThe necessity to develop a national classification system for Iranian traditional medicine
Safdari, R., Rezaeizadeh, H., Arji, G., Abbassian, A., Mokhtaran, M., Dehghan, R., & Shekalyou, S. (2019) · Health Information Management Journal · doi:10.1177/1833358319872820 · Cited by 5
“Generally, acceptance of the system by stakeholders, participation of leaders in planning, preparing a strategic plan for system implementation, identification of financial and human resources and having a clear policy and training method and techniques are among the essential elements that should be considered for as…”
BackgroundAhmadi, H., Nilashi, M., Ibrahim, O. A., & Raisian, K. (2016) · Europe PMC (PubMed Central) · doi:10.12865/chsj.42.01.12 · Cited by 5
“This is the point where people receive care for most of their everyday health needs” [8,9].”
BackgroundA Multi-Agent Solution for the Interoperability Issue in Health Information Systems.
Sernani, P., Claudi, A., Palazzo, L., Dolcini, G., & Dragoni, A. F. (2013) · Università Politecnica delle Marche (Università Politecnica delle Marche) · Cited by 5
Medhekar, A., & Nguyen, J. (2020) · Advances in medical technologies and clinical practice book series · doi:10.4018/978-1-7998-3274-4.ch008 · Cited by 5
Golburean, O., Pedersen, R., Melby, L. M. H., & Faxvaag, A. (2025) · JMIR Formative Research · doi:10.2196/63902 · Cited by 6
“The attitudes of health care professionals toward structured and standardized documentation may also depend on their perception of the benefits it provides [21,83].”
Mustafa, N. K., Ibrahim, R. B., Aljunid, S. M., Aizuddin, A. N., & Awang, Z. (2025) · Journal of Medical Internet Research · doi:10.2196/74226 · Cited by 8
“High SY enhances reliability and confidence in system use [41,45], but interface complexity introduced by advanced features without phased training or iterative usability testing can negatively impact usability [108,116].”
Raoof, M. M. (2024) · Journal of Information Security · doi:10.4236/jis.2024.152014 · Cited by 4
Tomaschek, R., Beeler, P. E., Grgičević, K., Müller, L. S., Merlo, C., & Hug, B. L. (2025) · Swiss Medical Weekly · doi:10.57187/s.3585 · Cited by 4
“According to similar studies, electronic health record portals may lack intuitive navigation [15, 26, 27].”
Cho, J., Yoo, S., Lee, E., & Lee, H. (2024) · JMIR Medical Informatics · doi:10.2196/53079 · Cited by 5
“Health information systems (HISs) play a vital role in the delivery of health care services, as they provide access to the patient’s medical records, help track treatment progress, and support health care providers in making care decisions [1-3].”
BackgroundFanta, G. B., & Erasmus, L. D. (2014) · INCOSE International Symposium · doi:10.1002/j.2334-5837.2014.00006.x · Cited by 4
“Ludwick & Doucette (2009) mention that strong leadership, using project management techniques, establishing standards and training staff help to insulate the project from possible risks that can prevent implementation success.”
BackgroundInfluentialBarron, S., & Manhas, S. (2011) · Journal of the Canadian Health Libraries Association / Journal de l Association de bilbiothèques de la santé du Canada · doi:10.5596/c11-044 · Cited by 4
“In Canada, there are a myriad of obstacles to overcome in the deployment of electronic health systems such as cost overruns, information security, and privacy [39].”
BackgroundOptimizing the Use and Adoption of Healthcare Information Systems
Bonney, W. (2016) · Advances in bioinformatics and biomedical engineering book series · doi:10.4018/978-1-4666-9882-6.ch007 · Cited by 4
van de Wetering, R. (2019) · Lecture notes in business information processing · doi:10.1007/978-3-030-04849-5_2 · Cited by 5
Factors Impacting Use of Health IT Applications
Ashtari, S., & Bellamy, A. (2019) · International Journal of Healthcare Information Systems and Informatics · doi:10.4018/ijhisi.2019100103 · Cited by 4
The many faces of implementation
Vimarlund, V., & Keller, C. (2014) · Cited by 4
Gill, M. J., Ody, M., Lynch, T., Jessiman-Perreault, L., & Krentz, H. B. (2016) · AIDS Care · doi:10.1080/09540121.2016.1139042 · Cited by 4
“One of the benefits promoted for the use of new technologies such as electronic health records (EHR) is to facilitate both the access to and the seamless timely transfer of complete healthcare information (Hoerbst & Ammenwerth, 2010; Ludwick & Doucette, 2009; Reiser, 1991; Shortliffe, 1999).”
BackgroundEvaluating the Critical Factors for Electronic Medical Record Adoption Using Fuzzy Approaches
Ahmadi, H., Darvishi, M., Nilashi, M., Almaee, A., Ibrahim, O., Zolghadri, A. H., Alizadeh, M., & Farahmand, M. (2015) · Cited by 4
Implementation of a Laboratory Information System in a Simulated Laboratory
Thomas, J. M. (2017) · American Society for Clinical Laboratory Science · doi:10.29074/ascls.30.2.92 · Cited by 4
The creation of theoretical frameworks to establish sustainable adoption of e-health in Libya
(2023) · Humanitarian and Natural Sciences Journal · doi:10.53796/hnsj4716 · Cited by 5
Meaningful Use of IT to Transform Healthcare: What Differentiates Success from Failure?
Regan, E. A., & Wang, J. (2014) · Journal of the Association for Information Systems · Cited by 4
Ludwick, D. (2009) · ElectronicHealthcare · Cited by 4
Self-citationKhalifa, M. (2016) · Journal of health informatics in developing countries · Cited by 4
A Technological Framework for EHR Interoperability: Experiences from Italy
Ciampi, M., Sicuranza, M., Esposito, A., Guarasci, R., & Pietro, G. D. (2017) · Communications in computer and information science · doi:10.1007/978-3-319-62704-5_6 · Cited by 4
Alharbi, S. A. (2017) · Journal of Advances in Health and Medical Sciences · doi:10.20474/jahms3.2.3 · Cited by 4
Person-Centered Approaches to Caregiving
Connor, K. I., Siebens, H. C., & Chodosh, J. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-417046-9.00014-3 · Cited by 4
Health information technologies for improved continuity of care: a South African perspective
Mostert-Phipps, N. (2011) · Nelson Mandela University Research Repository · Cited by 4
Randhawa, K., West, J., Skellern, K., & Josserand, E. (2020) · SSRN Electronic Journal · doi:10.2139/ssrn.3557255 · Cited by 3
Saxild, S., Wilson, P., de Voss, S. S., & Overbeck, G. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05671-w · Cited by 3
“In general, clinicians found the website to be credible, they were competent in accessing and utilizing it and had a positive attitude towards innovation which are all important precursor for successful implementation of new clinical practices [25, 26].”
Background
Metadata
- Authors
- LUDWICK, D., & DOUCETTE, J.
- Affiliations
- University of Alberta (CA)
- ORCID
- DOUCETTE, J
- Venue
- International Journal of Medical Informatics
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 78
- Issue
- 1
- Pages
- 22-31
- ISSN
- 1386-5056 (ISSN-L)
- OpenAlex
- W2005519248
- Cited by
- 668
- References
- 57
- Citations by year
- 2026: 4 · 2025: 15 · 2024: 21 · 2023: 35 · 2022: 30 · 2021: 38 · 2020: 40 · 2019: 43 · 2018: 55 · 2017: 50 · 2016: 46 · 2015: 56 · 2014: 57 · 2013: 46 · 2012: 41
- FWCI
- 64.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Medical Informatics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Business, Management and Accounting › Management Information Systems › Information Systems Theories and Implementation
- Social Sciences › Business, Management and Accounting › Management Information Systems › ERP Systems Implementation and Impact
- Keywords
- electronic health records, health information systems, primary care, implementation outcomes, user interface design, project management, privacy concerns, patient safety, employee training, implementation barriers, cross-national comparison
- MeSH terms
- Humans, Medical Informatics, Primary Health Care, Risk Factors, Medical Records Systems, Computerized, Internationality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
