What to expect from electronic patient record system implementation; lessons learned from published evidence

Ward Priestman, Shankar Sridharan, Helen Vigne, Richard Collins, Loretta Seamer, Neil J Sebire


Background: Numerous studies have examined specific factors related to success, failure and implications of Electronic patient record (EPR) system implementations, but usually limited to specific aspects.  

Objective: To review the published peer-reviewed literature and present findings regarding factors important in relation to successful EPR implementations and likely impact on subsequent clinical activity.

Method: Literature review

Results: 312 potential articles were identified on initial search of which 117 were relevant and included in the review. Several factors were related to implementation success, such as good leadership and management, infrastructure support, staff training and focus on workflows and usability. In general, EPR implementation is associated with improvements in documentation, and screening performance, and reduced prescribing errors, whereas there are minimal available data in other areas such as effects on clinical patient outcomes. The peer-reviewed literature appears to under-represent a range of technical factors important for EPR implementations, such as data migration from existing systems and impact of organisational readiness.

Conclusion: The findings presented here represent synthesis of data from peer-reviewed literature in the field and should be of value to provide the evidence-base for organisations considering how best to implement an EPR system.


EPR, implementation, benefits, systems

Full Text:



Akenroye AT, Kumthekar AA, Alevizos MK, Mowrey WB, Broder A, Al-Azmi SF, et al. Perspectives on electronic medical record implementation after two years of use in primary health care practice. Henriksen K, Battles JB, Marks ES, Lewin DI, editors. Stud Health Technol Inform. 2015 Oct;19(4):1–6.

Black S. Problems at Addenbrooke’s caused by failure to implement electronic patient record system effectively. Vol. 351, BMJ (Clinical research ed.). England; 2015. p. h5721.

Friedman LN, Halpern NA, Fackler JC. Implementing an electronic medical record. Crit Care Clin. 2007 Jul;23(3):347–81.

Noblin AM, Cortelyou-Ward K, Ton S. Electronic health record implementations: applying the principles of monitoring and controlling to achieve success. Health Care Manag (Frederick). 2011;30(1):45–50.

Slight SP, Quinn C, Avery AJ, Bates DW, Sheikh A. A qualitative study identifying the cost categories associated with electronic health record implementation in the UK. J Am Med Inform Assoc. 2014 Oct;21(e2):e226-31.

Joukes E, Cornet R, Abu-Hanna A, de Bruijne M, de Keizer N. End-user expectations during an electronic health record implementation: a case study in two academic hospitals. Stud Health Technol Inform. 2015;210:501–5.

Ratwani R, Fairbanks T, Savage E, Adams K, Wittie M, Boone E, et al. Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation. Appl Clin Inform. 2016 Nov;7(4):1069–87.

Houser SH, Johnson LA. Perceptions regarding electronic health record implementation among health information management professionals in Alabama: a statewide survey and analysis. Perspect Heal Inf Manag. 2008 May;5:6.

Bobadilla JL, Roe CS, Estes P, Lackey J, Steltenkamp CL. Leveraging Electronic Health Record Implementation to Facilitate Clinical and Operational Quality Improvement in an Ambulatory Surgical Clinic. J Ambul Care Manage. 2017;40(1):9–16.

Clarke A, Adamson J, Sheard L, Cairns P, Watt I, Wright J. Implementing electronic patient record systems (EPRs) into England’s acute, mental health and community care trusts: a mixed methods study. BMC Med Inform Decis Mak. 2015 Oct;15:85.

Chan KS, Kharrazi H, Parikh MA, Ford EW. Assessing electronic health record implementation challenges using item response theory. Am J Manag Care. 2016 Dec;22(12):e409–15.

McAlearney AS, Hefner JL, Sieck CJ, Huerta TR. The journey through grief: insights from a qualitative study of electronic health record implementation. Health Serv Res. 2015 Apr;50(2):462–88.

Bloomfield RAJ, Polo-Wood F, Mandel JC, Mandl KD. Opening the Duke electronic health record to apps: Implementing SMART on FHIR. Int J Med Inform. 2017 Mar;99:1–10.

Friend TH, Jennings SJ, Levine WC. Communication Patterns in the Perioperative Environment During Epic Electronic Health Record System Implementation. J Med Syst. 2017 Feb;41(2):22.

Retchin SM, Wenzel RP. Electronic medical record systems at academic health centers: advantages and implementation issues. Acad Med. 1999 May;74(5):493–8.

McAlearney AS, Robbins J, Hirsch A, Jorina M, Harrop JP. Perceived efficiency impacts following electronic health record implementation: an exploratory study of an urban community health center network. Int J Med Inform. 2010 Dec;79(12):807–16.

Crosson JC, Stroebel C, Scott JG, Stello B, Crabtree BF. Implementing an electronic medical record in a family medicine practice: communication, decision making, and conflict. Ann Fam Med. 2005;3(4):307–11.

Cresswell K, Morrison Z, Crowe S, Robertson A, Sheikh A. Anything but engaged: user involvement in the context of a national electronic health record implementation. Inform Prim Care. 2011;19(4):191–206.

Scott JT, Rundall TG, Vogt TM, Hsu J. Kaiser Permanente’s experience of implementing an electronic medical record: a qualitative study. BMJ. 2005 Dec;331(7528):1313–6.

Samoutis G, Soteriades ES, Kounalakis DK, Zachariadou T, Philalithis A, Lionis C. Implementation of an electronic medical record system in previously computer-naive primary care centres: a pilot study from Cyprus. Inform Prim Care. 2007;15(4):207–16.

Wibe T, Edwin E, Husby EH, Vedal T. Implementation of nursing care plan in the Electronic Patient Record (EPR) findings and experiences. Stud Health Technol Inform. 2006;122:309–13.

Terry AL, Brown JB, Bestard Denomme L, Thind A, Stewart M. Perspectives on electronic medical record implementation after two years of use in primary health care practice. J Am Board Fam Med. 2012;25(4):522–7.

Mc Quaid L, Breen P, Grimson J, Normand C, Dunne M, Delanty N, et al. Socio-technical considerations in epilepsy electronic patient record implementation. Int J Med Inform. 2010 May;79(5):349–60.

McAlearney AS, Sieck C, Hefner J, Robbins J, Huerta TR. Facilitating ambulatory electronic health record system implementation: evidence from a qualitative study. Biomed Res Int. 2013;2013:629574.

Jensen RE, Chan KS, Weiner JP, Fowles JB, Neale SM. Implementing electronic health record-based quality measures for developmental screening. Pediatrics. 2009 Oct;124(4):e648-54.

McAlearney AS, Hefner JL, Sieck C, Rizer M, Huerta TR. Fundamental issues in implementing an ambulatory care electronic health record. J Am Board Fam Med. 2015;28(1):55–64.

Harle CA, Listhaus A, Covarrubias CM, Schmidt SO, Mackey S, Carek PJ, et al. Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report. J Am Med Inform Assoc. 2016 Jan;23(1):74–9.

Scantlebury A, Sheard L, Watt I, Cairns P, Wright J, Adamson J. Exploring the implementation of an electronic record into a maternity unit: a qualitative study using Normalisation Process Theory. BMC Med Inform Decis Mak. 2017 Jan;17(1):4.

Souther E. Implementation of the electronic medical record: the team approach. Comput Nurs. 2001;19(2):47–55.

Fletcher GS, Payne TH. Selection and Implementation of an Electronic Health Record. PM R. 2017 May;9(5S):S4–12.

Yoon-Flannery K, Zandieh SO, Kuperman GJ, Langsam DJ, Hyman D, Kaushal R. A qualitative analysis of an electronic health record (EHR) implementation in an academic ambulatory setting. Inform Prim Care. 2008;16(4):277–84.

Collinsworth AW, Masica AL, Priest EL, Berryman CD, Kouznetsova M, Glorioso O, et al. Modifying the electronic health record to facilitate the implementation and evaluation of a bundled care program for intensive care unit delirium. EGEMS (Washington, DC). 2014;2(1):1121.

Ghazisaeidi M, Ahmadi M, Sadoughi F, Safdari R. An assessment of readiness for pre-implementation of electronic health record in Iran: a practical approach to implementation in general and teaching hospitals. Acta Med Iran. 2014;52(7):532–44.

Cucciniello M, Lapsley I, Nasi G, Pagliari C. Understanding key factors affecting electronic medical record implementation: a sociotechnical approach. BMC Health Serv Res. 2015 Jul;15:268.

Gross AH, Leib RK, Tonachel A, Tonachel R, Bowers DM, Burnard RA, et al. Teamwork and Electronic Health Record Implementation: A Case Study of Preserving Effective Communication and Mutual Trust in a Changing Environment. J Oncol Pract. 2016 Nov;12(11):1075–83.

Fullerton C, Aponte P, Hopkins R, Bragg D, Ballard DJ. Lessons learned from pilot site implementation of an ambulatory electronic health record. Proc (Bayl Univ Med Cent). 2006 Oct;19(4):303–10.

Corrao NJ, Robinson AG, Swiernik MA, Naeim A. Importance of testing for usability when selecting and implementing an electronic health or medical record system. J Oncol Pract. 2010 May;6(3):120–4.

Badger SL, Bosch RG, Toteja P. Rapid implementation of an electronic health record in an academic setting. J Healthc Inf Manag. 2005;19(2):34–40.

Laramee AS, Bosek M, Kasprisin CA, Powers-Phaneuf T. Learning from within to ensure a successful implementation of an electronic health record. Comput Inform Nurs. 2011 Aug;29(8):468–9.

Scott K, Van Norman J. Managing the complexity of a systemwide electronic medical record design and implementation: lessons for nurse leaders. Nurs Adm Q. 2009;33(2):109–15.

Zeng X. The Impacts of Electronic Health Record Implementation on the Health Care Workforce. N C Med J. 2016;77(2):112–4.

Lee T-T, Chang C-P. Nurses’ Experiences of an Initial and Re-Implemented Electronic Health Record Use. Stud Health Technol Inform. 2016;225:802–3.

McAlearney AS, Song PH, Robbins J, Hirsch A, Jorina M, Kowalczyk N, et al. Moving from good to great in ambulatory electronic health record implementation. J Healthc Qual. 2010;32(5):41–50.

Craven CK, Sievert MC, Hicks LL, Alexander GL, Hearne LB, Holmes JH. Experts speak: advice from key informants to small, rural hospitals on implementing the electronic health record system. Stud Health Technol Inform. 2013;192:608–12.

Bach DS, Risko KR, Zaran FK, Farber MS, Polk GJ. A Pharmacy Blueprint for Electronic Medical Record Implementation Success. Hosp Pharm. 2015 Jun;50(6):484–95.

Meeks DW, Takian A, Sittig DF, Singh H, Barber N. Exploring the sociotechnical intersection of patient safety and electronic health record implementation. J Am Med Inform Assoc. 2014 Feb;21(e1):e28-34.

McAlearney AS, Hefner JL, Sieck C, Rizer M, Huerta TR. Evidence-based management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence. Int J Med Inform. 2014 Jul;83(7):484–94.

Rizer MK, Kaufman B, Sieck CJ, Hefner JL, McAlearney AS. Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center. Perspect Heal Inf Manag. 2015;12:1g.

Mikulich VJ, Liu YC, Steinfeldt J, Schriger DL. Implementation of clinical guidelines through an electronic medical record: physician usage, satisfaction and assessment. Int J Med Inform. 2001 Oct;63(3):169–78.

Jones MR. “Computers can land people on Mars, why can’t they get them to work in a hospital?” Implementation of an Electronic Patient Record System in a UK Hospital. Methods Inf Med. 2003;42(4):410–5.

Hier DB, Rothschild A, LeMaistre A, Keeler J. Differing faculty and housestaff acceptance of an electronic health record one year after implementation. Stud Health Technol Inform. 2004;107(Pt 2):1300–3.

Doyle RJ, Wang N, Anthony D, Borkan J, Shield RR, Goldman RE. Computers in the examination room and the electronic health record: physicians’ perceived impact on clinical encounters before and after full installation and implementation. Fam Pract. 2012 Oct;29(5):601–8.

Brotzman GL, Guse CE, Fay DL, Schellhase KG, Marbella AM. Implementing an electronic medical record at a residency site: physicians’ perceived effects on quality of care, documentation, and productivity. WMJ. 2009 Apr;108(2):99–103.

Spencer DC, Choi D, English C, Girard D. The effects of electronic health record implementation on medical student educators. Teach Learn Med. 2012;24(2):106–10.

Chisolm DJ, Purnell TS, Cohen DM, McAlearney AS. Clinician perceptions of an electronic medical record during the first year of implementaton in emergency services. Pediatr Emerg Care. 2010 Feb;26(2):107–10.

Fleurant M, Kell R, Jenter C, Volk LA, Zhang F, Bates DW, et al. Factors associated with difficult electronic health record implementation in office practice. J Am Med Inform Assoc. 2012;19(4):541–4.

Takian A, Sheikh A, Barber N. We are bitter, but we are better off: case study of the implementation of an electronic health record system into a mental health hospital in England. BMC Health Serv Res. 2012 Dec;12:484.

Nour El Din MM. Physicians’ use of and attitudes toward electronic medical record system implemented at a teaching hospital in saudi arabia. J Egypt Public Health Assoc. 2007;82(5–6):347–64.

Shield RR, Goldman RE, Anthony DA, Wang N, Doyle RJ, Borkan J. Gradual electronic health record implementation: new insights on physician and patient adaptation. Ann Fam Med. 2010;8(4):316–26.

Ehrlich JR, Michelotti M, Blachley TS, Zheng K, Couper MP, Greenberg GM, et al. A Two-Year Longitudinal Assessment of Ophthalmologists’ Perceptions after Implementing an Electronic Health Record System. Appl Clin Inform. 2016 Oct;7(4):930–45.

Wylie MC, Baier RR, Gardner RL. Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island. Am J Med. 2014 Oct;127(10):1010.e21-7.

Crowson MG, Vail C, Eapen RJ. Influence of electronic medical record implementation on provider retirement at a major academic medical centre. J Eval Clin Pract. 2016 Apr;22(2):222–6.

Claret P-G, Sebbanne M, Bobbia X, Bonnec J-M, Pommet S, Jebali C, et al. First medical contact and physicians’ opinion after the implementation of an electronic record system. Am J Emerg Med. 2012 Sep;30(7):1235–40.

Sicotte C, Clavel S, Fortin MA. A cancer care electronic medical record highly integrated into clinicians’ workflow: users’ attitudes pre-post implementation. Eur J Cancer Care (Engl). 2016 Jul;

Moreland PJ, Gallagher S, Bena JF, Morrison S, Albert NM. Nursing satisfaction with implementation of electronic medication administration record. Comput Inform Nurs. 2012 Feb;30(2):97–103.

Tubaishat A. Evaluation of Electronic Health Record Implementation in Hospitals. Comput Inform Nurs. 2017 Feb;

Laramee AS, Bosek M, Shaner-McRae H, Powers-Phaneuf T. A comparison of nurse attitudes before implementation and 6 and 18 months after implementation of an electronic health record. Comput Inform Nurs. 2012 Oct;30(10):521–30.

Taylor SP, Ledford R, Palmer V, Abel E. We need to talk: an observational study of the impact of electronic medical record implementation on hospital communication. BMJ Qual Saf. 2014 Jul;23(7):584–8.

Irizarry T, Barton AJ. A sociotechnical approach to successful electronic health record implementation: five best practices for clinical nurse specialists. Clin Nurse Spec. 2013;27(6):283–5.

Nagy VT, Kanter MH. Implementing the electronic medical record in the exam room: the effect on physician-patient communication and patient satisfaction. Perm J. 2007;11(2):21–4.

Al-Azmi SF, Mohammed AM, Hanafi MI. Patients’ satisfaction with primary heath care in kuwait after electronic medical record implementation. J Egypt Public Health Assoc. 2006;81(5–6):277–300.

Schnipper JL, Gandhi TK, Wald JS, Grant RW, Poon EG, Volk LA, et al. Design and implementation of a web-based patient portal linked to an electronic health record designed to improve medication safety: the Patient Gateway medications module. Inform Prim Care. 2008;16(2):147–55.

Ose D, Kunz A, Pohlmann S, Hofmann H, Qreini M, Krisam J, et al. A Personal Electronic Health Record: Study Protocol of a Feasibility Study on Implementation in a Real-World Health Care Setting. JMIR Res Protoc. 2017 Mar;6(3):e33.

Kirkpatrick JP, Light KL, Walker RM, Georgas DL, Antoine PA, Clough RW, et al. Implementing and integrating a clinically driven electronic medical record for radiation oncology in a large medical enterprise. Front Oncol. 2013;3:69.

Keshavjee K, Troyan S, Holbrook AM, VanderMolen D. Measuring the success of electronic medical record implementation using electronic and survey data. Proceedings AMIA Symp. 2001;309–13.

Wormer BA, Colavita PD, Yokeley WT, Bradley JF 3rd, Williams KB, Walters AL, et al. Impact of implementing an electronic health record on surgical resident work flow, duty hours, and operative experience. Am Surg. 2015 Feb;81(2):172–7.

Yadav S, Kazanji N, K C N, Paudel S, Falatko J, Shoichet S, et al. Comparison of accuracy of physical examination findings in initial progress notes between paper charts and a newly implemented electronic health record. J Am Med Inform Assoc. 2017 Jan;24(1):140–4.

Pizziferri L, Kittler AF, Volk LA, Honour MM, Gupta S, Wang S, et al. Primary care physician time utilization before and after implementation of an electronic health record: a time-motion study. J Biomed Inform. 2005 Jun;38(3):176–88.

Verwey R, Claassen RAB, Rutgers MJ, de Witte LP. The implementation of an Electronic Nursing Record in a general hospital in the Netherlands: lessons to learn. Stud Health Technol Inform. 2008;141:130–8.

Chiang MF, Read-Brown S, Tu DC, Choi D, Sanders DS, Hwang TS, et al. Evaluation of electronic health record implementation in ophthalmology at an academic medical center (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2013 Sep;111:70–92.

Spellman Kennebeck S, Timm N, Farrell MK, Spooner SA. Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department. J Am Med Inform Assoc. 2012;19(3):443–7.

Ward MJ, Froehle CM, Hart KW, Collins SP, Lindsell CJ. Transient and sustained changes in operational performance, patient evaluation, and medication administration during electronic health record implementation in the emergency department. Ann Emerg Med. 2014 Mar;63(3):320–8.

Ward MJ, Landman AB, Case K, Berthelot J, Pilgrim RL, Pines JM. The effect of electronic health record implementation on community emergency department operational measures of performance. Ann Emerg Med. 2014 Jun;63(6):723–30.

Reddy KG, Yu JC. The impact of electronic medical record implementation on the outpatient volumes of a midsize academic center. Ann Plast Surg. 2014 Sep;73(3):330–2.

Patterson ME, Marken P, Zhong Y, Simon SD, Ketcherside W. Comprehensive electronic medical record implementation levels not associated with 30-day all-cause readmissions within Medicare beneficiaries with heart failure. Appl Clin Inform. 2014;5(3):670–84.

Rupp KJ, Ham NJ, Blankenship DE, Payton ME, Murray KA. Pre and post hoc analysis of electronic health record implementation on emergency department metrics. Proc (Bayl Univ Med Cent). 2017 Apr;30(2):147–50.

Singh RP, Bedi R, Li A, Kulkarni S, Rodstrom T, Altus G, et al. The Practice Impact of Electronic Health Record System Implementation Within a Large Multispecialty Ophthalmic Practice. JAMA Ophthalmol. 2015 Jun;133(6):668–74.

Haidar YM, Moshtaghi O, Mahboubi H, Ghavami Y, Ziai K, Hojjat H, et al. Association Between Electronic Medical Record Implementation and Otolaryngologist Productivity in the Ambulatory Setting. JAMA Otolaryngol Head Neck Surg. 2017 Jan;143(1):20–4.

McDowell J, Wu A, Ehrenfeld JM, Urman RD. Effect of the Implementation of a New Electronic Health Record System on Surgical Case Turnover Time. J Med Syst. 2017 Mar;41(3):42.

Risko N, Anderson D, Golden B, Wasil E, Barrueto F, Pimentel L, et al. The impact of electronic health record implementation on emergency physician efficiency and patient throughput. Healthc (Amsterdam, Netherlands). 2014 Sep;2(3):201–4.

Thirukumaran CP, Dolan JG, Reagan Webster P, Panzer RJ, Friedman B. The impact of electronic health record implementation and use on performance of the Surgical Care Improvement Project measures. Health Serv Res. 2015 Feb;50(1):273–89.

Flatow VH, Ibragimova N, Divino CM, Eshak DSA, Twohig BC, Bassily-Marcus AM, et al. Quality Outcomes in the Surgical Intensive Care Unit after Electronic Health Record Implementation. Appl Clin Inform. 2015;6(4):611–8.

Han JE, Rabinovich M, Abraham P, Satyanarayana P, Liao TV, Udoji TN, et al. Effect of Electronic Health Record Implementation in Critical Care on Survival and Medication Errors. Am J Med Sci. 2016 Jun;351(6):576–81.

Rosenbloom ST, Qi X, Riddle WR, Russell WE, DonLevy SC, Giuse D, et al. Implementing pediatric growth charts into an electronic health record system. J Am Med Inform Assoc. 2006;13(3):302–8.

Albuquerque K V, Miller AA, Roeske JC. Implementation of electronic checklists in an oncology medical record: initial clinical experience. J Oncol Pract. 2011 Jul;7(4):222–6.

Dean SM, Gilmore-Bykovskyi A, Buchanan J, Ehlenfeldt B, Kind AJH. Design and Hospitalwide Implementation of a Standardized Discharge Summary in an Electronic Health Record. Jt Comm J Qual patient Saf. 2016 Dec;42(12):555–AP11.

Grieger DL, Cohen SH, Krusch DA. A pilot study to document the return on investment for implementing an ambulatory electronic health record at an academic medical center. J Am Coll Surg. 2007 Jul;205(1):89–96.

Evans DC, Nichol WP, Perlin JB. Effect of the implementation of an enterprise-wide Electronic Health Record on productivity in the Veterans Health Administration. Health Econ Policy Law. 2006 Apr;1(Pt 2):163–9.

Howley MJ, Chou EY, Hansen N, Dalrymple PW. The long-term financial impact of electronic health record implementation. J Am Med Inform Assoc. 2015 Mar;22(2):443–52.

Riahi S, Fischler I, Stuckey MI, Klassen PE, Chen J. The Value of Electronic Medical Record Implementation in Mental Health Care: A Case Study. JMIR Med informatics. 2017 Jan;5(1):e1.

Hulse NC, Lee J, Borgeson T. Visualization of Order Set Creation and Usage Patterns in Early Implementation Phases of an Electronic Health Record. AMIA . Annu Symp proceedings AMIA Symp. 2016;2016:657–66.

Sonnenberg FA, Hagerty CG, Acharya J, Pickens DS, Kulikowski CA. Vocabulary requirements for implementing clinical guidelines in an electronic medical record: a case study. AMIA . Annu Symp proceedings AMIA Symp. 2005;709–13.

Cook PP, Rizzo S, Gooch M, Jordan M, Fang X, Hudson S. Sustained reduction in antimicrobial use and decrease in methicillin-resistant Staphylococcus aureus and Clostridium difficile infections following implementation of an electronic medical record at a tertiary-care teaching hospital. J Antimicrob Chemother. 2011 Jan;66(1):205–9.

Gascon F, Herrera I, Vazquez C, Jimenez P, Jimenez J, Real C, et al. Electronic health record: design and implementation of a lab test request module. Int J Med Inform. 2013 Jun;82(6):514–21.

Raval M V, Rust L, Thakkar RK, Kurtovic KJ, Nwomeh BC, Besner GE, et al. Development and implementation of an electronic health record generated surgical handoff and rounding tool. J Med Syst. 2015 Feb;39(2):8.

Finn A, Bondarenka C, Edwards K, Hartwell R, Letton C, Perez A. Evaluation of electronic health record implementation on pharmacist interventions related to oral chemotherapy management. J Oncol Pharm Pract. 2016 Aug;

Carayon P, Wetterneck TB, Cartmill R, Blosky MA, Brown R, Hoonakker P, et al. Medication Safety in Two Intensive Care Units of a Community Teaching Hospital After Electronic Health Record Implementation: Sociotechnical and Human Factors Engineering Considerations. J Patient Saf. 2017 Feb;

Kritz S, Brown LSJ, Chu M, John-Hull C, Madray C, Zavala R, et al. Electronic medical record system at an opioid agonist treatment programme: study design, pre-implementation results and post-implementation trends. J Eval Clin Pract. 2012 Aug;18(4):739–45.

Harshberger CA, Harper AJ, Carro GW, Spath WE, Hui WC, Lawton JM, et al. Outcomes of computerized physician order entry in an electronic health record after implementation in an outpatient oncology setting. J Oncol Pract. 2011 Jul;7(4):233–7.

Gunningberg L, Dahm MF, Ehrenberg A. Accuracy in the recording of pressure ulcers and prevention after implementing an electronic health record in hospital care. Qual Saf Health Care. 2008 Aug;17(4):281–5.

Gunningberg L, Fogelberg-Dahm M, Ehrenberg A. Improved quality and comprehensiveness in nursing documentation of pressure ulcers after implementing an electronic health record in hospital care. J Clin Nurs. 2009 Jun;18(11):1557–64.

Herrin J, da Graca B, Nicewander D, Fullerton C, Aponte P, Stanek G, et al. The effectiveness of implementing an electronic health record on diabetes care and outcomes. Health Serv Res. 2012 Aug;47(4):1522–40.

McGuire MJ, Noronha G, Samal L, Yeh H-C, Crocetti S, Kravet S. Patient safety perceptions of primary care providers after implementation of an electronic medical record system. J Gen Intern Med. 2013 Feb;28(2):184–92.

Wang JJ, Sebek KM, McCullough CM, Amirfar SJ, Parsons AS, Singer J, et al. Sustained improvement in clinical preventive service delivery among independent primary care practices after implementing electronic health record systems. Prev Chronic Dis. 2013 Aug;10:E130.

Reed M, Huang J, Brand R, Graetz I, Neugebauer R, Fireman B, et al. Implementation of an outpatient electronic health record and emergency department visits, hospitalizations, and office visits among patients with diabetes. JAMA. 2013 Sep;310(10):1060–5.

Hye RJ, Smith AE, Wong GH, Vansomphone SS, Scott RD, Kanter MH. Leveraging the electronic medical record to implement an abdominal aortic aneurysm screening program. J Vasc Surg. 2014 Jun;59(6):1535–42.

Akenroye AT, Kumthekar AA, Alevizos MK, Mowrey WB, Broder A. Implementing an Electronic Medical Record-Based Reminder for Cardiovascular Risk Screening in Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2017 May;69(5):625–32.

DOI: http://dx.doi.org/10.14236/jhi.v25i2.1007


  • There are currently no refbacks.

This is an open access journal, which means that all content is freely available without charge to the user or their institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal starting from Volume 21 without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open accessFor permission regarding papers published in previous volumes, please contact us.

Privacy statement: The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.

Online ISSN 2058-4563 - Print ISSN 2058-4555. Published by BCS, The Chartered Institute for IT