Implementing structured data in Electronic Health Records

Implementing an Electronic Health Record (EHR) in a healthcare organisation and improving the adoption of structured data recording are both complicated change processes involving technical solutions as well as changing work processes and human interactions. In this thesis we investigate both these processes. We especially focus on the perceptions of healthcare providers and how these perceptions change when confronted with the consequences of the implementation of a new EHR.
In three studies we describe the effects of implementing a structured and standardised EHR on healthcare providers’ perceptions of EHR use and performance, and we assess whether these effects differ for centres starting with a paper-based or legacy EHR at baseline. In two further studies we determine factors that influence healthcare professionals’ intention to record structured data.
The outcomes described in this thesis can help with the difficult processes of implementing a new EHR or increasing the adoption of structured data recording. We provide an insight into what end-users actually value during an EHR implementation and what they expect to gain from the new system. Neglecting these aspects might result in a less effective EHR implementation and the end-users being disappointed. We also show what the effects of an implementation can be on the documentation burden for healthcare professionals. We created a model and questionnaire describing barriers and facilitators to increase the intention of healthcare professionals to start recording data in a structured manner. These were used to create an overview of the current state of affairs concerning structured data recording.