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Table 2 Overview of studies included in the systematic literature review

From: Implementing electronic health records in hospitals: a systematic literature review

Author Country/region Main objective of study Type of research Data collection Participants (sample size, response rate) Hospital type Impact factor* Citations**
Aarts et al. [21] The Netherlands To examine the three theoretical aspects (social process, emergent change, socially negotiated judgments) to understand the implementation process. Qualitative Semi-structured interviews, observations, document analysis 10 members of the project team from different disciplines Teaching hospital 4.329 194
Aarts & Berg [22] The Netherlands To understand the outcomes of CPOE implementation using a heuristic model and to identify factors that determine successful implementation. Qualitative Open interviews, observations, document analysis 25 interviews with project team members, physicians, nurses, technical and clerical personnel Teaching hospital & regional hospital 1.090 47
Ash et al. [23] USA/Virginia, Washington, California To find out how some hospitals had successfully implemented POE. Quantitative and Qualitative Survey, semi-structured interviews, focus groups, observations Quantitative: 1000 hospitals (37% response rate) Qualitative: 32 interviews with physicians, nurses, pharmacists, IT-staff, administrators quantitative : 1000 hospitals qualitative: 2 teaching hospitals, 2 community hospitals - 37
Ash et al. [24] USA/Virginia, Washington, California To describe perceptions of POE held by diverse professionals at both teaching and nonteaching sites where POE has been successfully implemented. Qualitative Semi-structured interviews, focus groups, observations Physicians, administrators, and information technology personnel 2 teaching hospitals, 2 community hospitals 4.329 160
Boyer et al. [25] France To examine health care professionals’ opinions on the critical events (opportunities and barriers) surrounding EMR implementation Qualitative Semi-structured interviews 115 psychiatrists, nurses, psychologists and social assistants, secretaries and administrative professionals Psychiatric teaching hospital 0.420 0
Cresswell et al. [26] United Kingdom To explore how EHR has shaped professional practice and what consequences these changes had for organizational functioning, record keeping and patient care. Qualitative Semi-structured interviews, observations, documents 66 users and other hospital staff, 3 hospitals, 1 acute setting, 1 community and mental health. - 13
Ford et al. [27] USA To assess complete versus incomplete HIT implementation levels among U.S. hospitals in light of the various technology adoption strategies employed and to discuss the implications with respect to meaningful use for hospitals that have adopted the different HIT strategies. Quantitative Survey 1,814 hospitals All kinds of hospitals - 13
Gastaldi et al. [28] Italy To examine how hospital performance can be improved by enhancing and balancing knowledge exploration and exploitation capabilities through the development of an EMR. Qualitative Interviews, archival data 27 interviews in three hospitals 3 hospitals, 2 teaching and 1 non-teaching - 2
Houser & Johnson [29] USA/Alabama 1. To determine the status of implementation of EHRs in hospitals in the state of Alabama; 2. To assess the factors that are driving the decision making for implementation of EHRs; and 3. To assess the perceptions of HIM professionals of the benefits, barriers, and risks that are associated with implementation of EHRs. Quantitative Survey 131 directors in health information management, 69% response rate Members of the Alabama Hospital Association - 19
Jaana et al. [30] USA/Iowa To present an overview of clinical information systems (IS) in hospitals and to analyze the level of electronic medical records (EMR) implementation in relation to clinical IS capabilities and organizational characteristics. Quantitative Survey 116 CEOs or CIOs, 84% response rate Nonfederal hospitals - 3
Katsma et al. [31] The Netherlands To contribute to the developments in method engineering, which promises a better participation of the user. Qualitative Interviews 12 people, being supported sponsor, process owner or key-user 4 hospitals - 4
Ovretveit et al. [32] Sweden To describe and assess an implementation in one hospital and analyze this in relation to factors suggested by previous research to be important for successful implementation as well as in relation to a published USA case study, which used similar methods. Qualitative Interviews 30 persons, project leaders, supervisors, heads of division and clinics, instructor, nurses, physicians, and doctor secretary Teaching hospital 2.480 86
Poon et al. [33] USA To provide more insight into the challenges to CPOE implementation. Qualitative Interviews 52 CIOs/CFOs/CMOs and senior managers from 26 hospitals (46 hospitals were contacted: 57% response rate Both teaching and non-teaching hospitals 3.748 269
Rivard et al. [34] Canada To propose a substantive theory – a theory developed for a particular area of inquiry (Gregor, 2006) – to provide an organizational culture-based explanation of the level of difficulty of a CIS implementation and of the implementation practices that can help reduce the level of difficulty of this process. Qualitative Interviews 43 people, physicians, nurses, and administrators 3 hospitals, 2 teaching and 1 community hospital 2.654 9
Scott et al. [35] USA/Hawaii To examine users’ attitudes to implementation of an electronic medical record system in Kaiser Permanente Hawaii. Qualitative Interviews 26 senior physicians, managers and project team members One hospital, 4 clinics 13.511 174
Simon et al. [36] USA/Massachusetts To identify attitudes, behaviors and experiences that would constitute useful lessons for other hospitals embarking on CPOE implementation Qualitative Interviews, observations 24 physicians, nurses and pharmacists 5 community hospitals - 2
Takian et al. [37] England To report on a case study of the implementation of an EHR (RiO) into a mental health setting delivered though the NPfIT and analyzed using our adapted ‘socio technical changing framework’. Qualitative Interviews, observations, document analysis 48 interviews with senior managers, implementation team members, healthcare practitioners Mental health hospital 2.254 0
Ward et al. [38] USA To examine the impact of clinical information system implementation on nurses’ perceptions of workflow and patient care throughout the implementation process. Quantitative Survey 705 nurses Rural hospital - 3
Ward et al. [39] USA To examine staff perceptions of patient care quality and the processes before and after implementation of a comprehensive clinical information system (CIS) in critical access hospitals (CAHs). Quantitative Survey 840 nurses, providers, and other clinical staff Critical access hospitals 2.540 0
Weir et al. [19] USA/Utah To identify factors that discriminate successful from non-successful implementation of OE/RR 2.5 in order to prepare for the next version. Quantitative Survey 52 medical administration staff, administrators, support staff, users (ward clerks, physicians, and nurses), and physician opinion leaders (92 received survey, thus 57% response rate) 6 hospitals - 29
Yoon-Flannery et al. [40] USA/New York To determine pre-implementation perspectives of institutional, practice and vendor leadership regarding best practice for implementation of two ambulatory electronic health records (EHRs) at an academic institution. Qualitative Interviews 31 interviews with institutional leaders, practice leaders and vendor leaders. Teaching hospital - 25
  1. *The 5-year impact factor based on the Journal Citation Reports 2011 is used in this table.
  2. **The number of citations is identified using