The Article in Brief

Background: Although electronic medical records (EMRs) are thought to have many advantages over paper medical records, they are not widely used in primary care practices. This study examined how a primary care doctors’ office implemented an EMR.
What This Study Found: Members of the practice had different views about the value of the EMR and how it should be used. The practice had a “top down” decision-making style, so decisions about the EMR were made by one practice leader. Because other staff weren’t involved in planning for the EMR, there were disruptions in practice functions, such as scheduling patients. In addition, reminder systems that were used in the paper medical records were not transferred to the EMRs.
Implications:
• Successfully implementing an EMR requires planning and communication.
• Practice members are likely to have different points of view about large-scale organizational changes, such as implementing EMRs. Primary care practices that recognize and work with different viewpoints are best able to make changes.
• Each primary care practice has unique issues that must be taken into account before, during, and after the implementation of an EMR. During the implementation process, conflicts should be allowed to arise safely and communication should be encouraged.