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Cited by 204Electronic Health Records SystemsInformation Systems Theories and ImplementationERP Systems Implementation and Impact

Improving quality through effective implementation of information technology in healthcare

Ovretveit, J., Scott, T., Rundall, T. G., Shortell, S. M., Brommels, M.·2007·International Journal for Quality in Health Care
DOI 10.1093/intqhc/mzm031
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Abstract

OBJECTIVE: To describe an implementation of one information technology system (electronic medical record, EMR) in one hospital, the perceived impact, the factors thought to help and hinder implementation and the success of the system and compare this with theories of effective IT implementation. To draw on previous research, empirical data from this study is used to develop IT implementation theory. DESIGN: Qualitative case study, replicating the methods and questions of a previously published USA EMR implementation study using semi-structured interviews and documentation. SETTING: Large Swedish teaching hospital shortly after a merger of two hospital sites. PARTICIPANTS: Thirty senior clinicians, managers, project team members, doctors and nurses. RESULTS: The Swedish implementation was achieved within a year and for under half the budget, with a generally popular EMR which was thought to save time and improve the quality of patient care. Evidence from this study and findings from the more problematic USA implementation case suggests that key factors for cost effective implementation and operation were features of the system itself, the implementation process and the conditions under which the implementation was carried out. CONCLUSION: There is empirical support for the IT implementation theory developed in this study, which provides a sound basis for future research and successful implementation. Successful implementation of an EMR is likely with an intuitive system, requiring little training, already well developed for clinical work but allowing flexibility for development, where clinicians are involved in selection and in modification for their department needs and where a realistic timetable is made using an assessment of the change-capability of the organization. Once a system decision is made, the implementation should be driven by top and departmental leaders assisted by competent project teams involving information technology specialists and users. Corrections for unforeseen eventualities will be needed, especially with less developed systems, requiring regular reviews of progress and modifications to systems and timetables to respond to user needs.

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Crossref · 10.1093/intqhc/mzm031

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  • Existing literature on the benefits of electronic records is largely U.S. or primary care based and reports potential rather than actual benefits, with a large proportion of this evidence reporting the potential for electronic records to improve patient safety.

    “Existing literature on the benefits of electronic records is largely U.S or primary care based [18–34] and reports ‘potential’ rather than actual benefits; with a large proportion of this evidence reporting the potential for electronic records to improve patient safety [19, 21, 23, 27–30].”

    From Exploring the implementation of an electronic record into a maternity unit: a qualitative study using Normalisation Process Theory (2017) · cites this paper as [19]

  • In accordance with existing literature, evidence of actual benefits reported in this study was limited to a number of clinically orientated benefits surrounding improved information availability, accessibility and legibility.

    “In accordance with existing literature, evidence of actual benefits reported in our study were limited to a number of ‘clinically orientated’ benefits surrounding improved information availability, accessibility and legibility [19, 23, 31–34].”

    From Exploring the implementation of an electronic record into a maternity unit: a qualitative study using Normalisation Process Theory (2017) · cites this paper as [19]

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Authors
Ovretveit, J., Scott, T., Rundall, T. G., Shortell, S. M., & Brommels, M.
Affiliations
  • University of St Andrews (GB)
  • University of California, Berkeley (US)
  • University of Helsinki (FI)
ORCID
Venue
International Journal for Quality in Health Care
Publisher
Oxford University Press (OUP)
Published
2007-08-01
Volume
19
Issue
5
Pages
259-266
ISSN
  • 1353-4505 (ISSN-L)
  • 1464-3677
DOI
10.1093/intqhc/mzm031
OpenAlex
W2167472681
Cited by
204
References
19
Citations by year
2026: 1 · 2025: 7 · 2024: 12 · 2023: 3 · 2022: 8 · 2021: 9 · 2020: 5 · 2019: 11 · 2018: 10 · 2017: 15 · 2016: 10 · 2015: 11 · 2014: 18 · 2013: 12 · 2012: 14
FWCI
22.80
Type
journal article
Language
en
Open access
closed
Locations
  • International Journal for Quality in Health Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Social Sciences › Sociology and Political Science › 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 technology implementation, hospital mergers, cost-effective implementation, quality of care, implementation barriers and facilitators, project teams
MeSH terms
Attitude of Health Personnel, Cost-Benefit Analysis, Health Facility Merger, Health Plan Implementation, Hospital Information Systems, Humans, Interviews as Topic, Medical Staff, Hospital, Organizational Innovation, Quality Assurance, Health Care, Sweden, Program Evaluation, Medical Records Systems, Computerized, Program Development, Organizational Case Studies

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