Health Affairs, 23, no. 2 (2004): 116-126 doi: 10.1377/hlthaff.23.2.116 © 2004 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

This Article Full Text (HTML) Reprint (PDF) Submit a response to this article Alert me when this article is cited Alert me when Comments are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (73) Citing Articles via Google Scholar Google Scholar Articles by Miller, R. H. Articles by Sim, I. Search for Related Content PubMed PubMed Citation Articles by Miller, R. H. Articles by Sim, I. Related Collections Internet And Health Business Of Health Physicians Quality Of Care Research And Technology Consumer Issues Related Blog Posts

Pursuit Of Quality

Physicians’ Use Of Electronic Medical Records: Barriers And Solutions

The electronic medical record (EMR) is an enabling technology that allows physician practices to pursue more powerful quality improvement programs than is possible with paper-based records. However, achieving quality improvement through EMR use is neither low-cost nor easy. Based on a qualitative study of physician practices that had implemented an EMR, we found that quality improvement depends heavily on physicians’ use of the EMR—and not paper—for most of their daily tasks. We identified key barriers to physicians’ use of EMRs. We then suggest policy interventions to overcome these barriers, including providing work/practice support systems, improving electronic clinical data exchange, and providing financial rewards for quality improvement.

                      What's this?

Related Blog Posts:

This article has been cited by other articles:

				K. C Nanji, J. Cina, N. Patel, W. Churchill, T. K Gandhi, and E. G Poon Overcoming Barriers to the Implementation of a Pharmacy Bar Code Scanning System for Medication Dispensing: A Case Study JAMIA, September 1, 2009; 16(5): 645 - 650. [Abstract] [Full Text] [PDF]

				C. P. Roth, Y.-W. Lim, J. M. Pevnick, S. M. Asch, and E. A. McGlynn The Challenge of Measuring Quality of Care From the Electronic Health Record American Journal of Medical Quality, September 1, 2009; 24(5): 385 - 394. [Abstract] [PDF]

				K. C. Nanji, J. Cina, N. Patel, W. Churchill, T. K. Gandhi, and E. G. Poon Overcoming Barriers to the Implementation of a Pharmacy Bar Code Scanning System for Medication Dispensing: A Case Study J. Am. Med. Inform. Assoc., September 1, 2009; 16(5): 645 - 650. [Abstract] [Full Text] [PDF]

				L. Zhou, C. S Soran, C. A Jenter, L. A Volk, E. Orav, D. W Bates, and S. R Simon The Relationship between Electronic Health Record Use and Quality of Care over Time JAMIA, July 1, 2009; 16(4): 457 - 464. [Abstract] [Full Text] [PDF]

				L. Zhou, C. S. Soran, C. A. Jenter, L. A. Volk, E. J. Orav, D. W. Bates, and S. R. Simon The Relationship between Electronic Health Record Use and Quality of Care over Time J. Am. Med. Inform. Assoc., July 1, 2009; 16(4): 457 - 464. [Abstract] [Full Text] [PDF]

				W. F. Gellad, A. S. Detsky, and N. K. Choudhry Implications of recent clinical trials on pay-for-performance Am. J. Health Syst. Pharm., May 1, 2009; 66(9): 864 - 867. [Full Text] [PDF]

				W. V. Sujansky, J. M. Overhage, S. Chang, J. Frohlich, and S. A. Faus The Development of a Highly Constrained Health Level 7 Implementation Guide to Facilitate Electronic Laboratory Reporting to Ambulatory Electronic Health Record Systems J. Am. Med. Inform. Assoc., May 1, 2009; 16(3): 285 - 290. [Abstract] [Full Text] [PDF]

				A. Yip, M. Leduc, V. Teo, M. Timmons, and M. J. Schull A Novel Method to Link and Validate Routinely Collected Emergency Department Clinical Data to Measure Quality of Care American Journal of Medical Quality, May 1, 2009; 24(3): 185 - 191. [Abstract] [PDF]

				E. A. Miller and D. M. West Where's the Revolution? Digital Technology and Health Care in the Internet Age Journal of Health Politics Policy and Law, April 1, 2009; 34(2): 261 - 284. [Abstract] [PDF]

				T. G. Ferris, S. A. Johnson, J. P. T. Co, M. Backus, J. Perrin, D. W. Bates, and E. G. Poon Electronic Results Management in Pediatric Ambulatory Care: Qualitative Assessment Pediatrics, January 1, 2009; 123(Supplement_2): S85 - S91. [Abstract] [Full Text] [PDF]

				T. P. Thyvalikakath, V. Monaco, H. B. Thambuganipalle, and T. Schleyer A usability evaluation of four commercial dental computer-based patient record systems J Am Dent Assoc, December 1, 2008; 139(12): 1632 - 1642. [Abstract] [Full Text] [PDF]

				A. S. Kazley and Y. A. Ozcan Do Hospitals With Electronic Medical Records (EMRs) Provide Higher Quality Care?: An Examination of Three Clinical Conditions Med Care Res Rev, August 1, 2008; 65(4): 496 - 513. [Abstract] [PDF]

				A. L. Terry, C. F. Thorpe, G. Giles, J. B. Brown, S. B. Harris, G. J. Reid, A. Thind, and M. Stewart Implementing electronic health records: Key factors in primary care Can Fam Physician, May 1, 2008; 54(5): 730 - 736. [Abstract] [Full Text] [PDF]

				J. Ovretveit, T. Scott, T. G. Rundall, S. M. Shortell, and M. Brommels Improving quality through effective implementation of information technology in healthcare Int. J. Qual. Health Care, October 1, 2007; 19(5): 259 - 266. [Abstract] [Full Text] [PDF]

				H. G. Lo, L. P. Newmark, C. Yoon, L. A. Volk, V. L. Carlson, A. F. Kittler, M. Lippincott, T. Wang, and D. W. Bates Electronic Health Records in Specialty Care: A Time-Motion Study J. Am. Med. Inform. Assoc., September 1, 2007; 14(5): 609 - 615. [Abstract] [Full Text] [PDF]

				M. I. Harrison, R. Koppel, and S. Bar-Lev Unintended Consequences of Information Technologies in Health Care An Interactive Sociotechnical Analysis J. Am. Med. Inform. Assoc., September 1, 2007; 14(5): 542 - 549. [Abstract] [Full Text] [PDF]

				J. S. Simon, T. G. Rundall, and S. M. Shortell Adoption of Order Entry with Decision Support for Chronic Care by Physician Organizations J. Am. Med. Inform. Assoc., July 1, 2007; 14(4): 432 - 439. [Abstract] [Full Text] [PDF]

				S. M. Davidson and J. Heineke Toward an Effective Strategy for the Diffusion and Use of Clinical Information Systems J. Am. Med. Inform. Assoc., May 1, 2007; 14(3): 361 - 367. [Abstract] [Full Text] [PDF]

				S. R. Simon, R. Kaushal, P. D. Cleary, C. A. Jenter, L. A. Volk, E. J. Orav, E. Burdick, E. G. Poon, and D. W. Bates Physicians and Electronic Health Records: A Statewide Survey Arch Intern Med, March 12, 2007; 167(5): 507 - 512. [Abstract] [Full Text] [PDF]

				S. R. Simon, R. Kaushal, P. D. Cleary, C. A. Jenter, L. A. Volk, E. G. Poon, E. J. Orav, H. G. Lo, D. H. Williams, and D. W. Bates Correlates of Electronic Health Record Adoption in Office Practices: A Statewide Survey J. Am. Med. Inform. Assoc., January 1, 2007; 14(1): 110 - 117. [Abstract] [Full Text] [PDF]

				R. H. Miller and C. E. West The Value Of Electronic Health Records In Community Health Centers: Policy Implications Health Aff., January 1, 2007; 26(1): 206 - 214. [Abstract] [Full Text] [PDF]

				D. C. Stockwell and A. D. Slonim Quality and Safety in the Intensive Care Unit J Intensive Care Med, July 1, 2006; 21(4): 199 - 210. [Abstract] [PDF]

				L. P. Casalino The Federal Trade Commission, Clinical Integration, and the Organization of Physician Practice Journal of Health Politics Policy and Law, June 1, 2006; 31(3): 569 - 585. [Abstract] [PDF]

				B. Chaudhry, J. Wang, S. Wu, M. Maglione, W. Mojica, E. Roth, S. C. Morton, and P. G. Shekelle Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care Ann Intern Med, May 16, 2006; 144(10): 742 - 752. [Abstract] [Full Text] [PDF]

				G. F. Anderson, B. K. Frogner, R. A. Johns, and U. E. Reinhardt Health care spending and use of information technology in OECD countries. Health Aff., May 1, 2006; 25(3): 819 - 831. [Abstract] [Full Text] [PDF]

				E. W. Ford, N. Menachemi, and M. T. Phillips Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless? J. Am. Med. Inform. Assoc., January 1, 2006; 13(1): 106 - 112. [Abstract] [Full Text] [PDF]

				T. D. Sequist, T. Cullen, and J. Z. Ayanian Information Technology as a Tool to Improve the Quality of American Indian Health Care Am J Public Health, December 1, 2005; 95(12): 2173 - 2179. [Abstract] [Full Text] [PDF]

				L. Poissant, J. Pereira, R. Tamblyn, and Y. Kawasumi The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review J. Am. Med. Inform. Assoc., September 1, 2005; 12(5): 505 - 516. [Abstract] [Full Text] [PDF]

				R. Hillestad, J. Bigelow, A. Bower, F. Girosi, R. Meili, R. Scoville, and R. Taylor Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs Health Aff., September 1, 2005; 24(5): 1103 - 1117. [Abstract] [Full Text] [PDF]

				R. H. Miller, C. West, T. M. Brown, I. Sim, and C. Ganchoff The Value Of Electronic Health Records In Solo Or Small Group Practices Health Aff., September 1, 2005; 24(5): 1127 - 1137. [Abstract] [Full Text] [PDF]

				D. W. Bates Physicians And Ambulatory Electronic Health Records Health Aff., September 1, 2005; 24(5): 1180 - 1189. [Abstract] [Full Text] [PDF]

				R. Taylor, A. Bower, F. Girosi, J. Bigelow, K. Fonkych, and R. Hillestad Promoting Health Information Technology: Is There A Case For More-Aggressive Government Action? Health Aff., September 1, 2005; 24(5): 1234 - 1245. [Abstract] [Full Text] [PDF]

				C. M. Kilo Transforming Care: Medical Practice Design And Information Technology Health Aff., September 1, 2005; 24(5): 1296 - 1301. [Abstract] [Full Text] [PDF]

				D. Gans, J. Kralewski, T. Hammons, and B. Dowd Medical Groups' Adoption Of Electronic Health Records And Information Systems Health Aff., September 1, 2005; 24(5): 1323 - 1333. [Abstract] [Full Text] [PDF]

				P. Basch Electronic Health Records and the National Health Information Network: Affordable, Adoptable, and Ready for Prime Time? Ann Intern Med, August 2, 2005; 143(3): 227 - 228. [Full Text] [PDF]

				C. J. Wang, R. S. Marken, R. C. Meili, J. B. Straus, A. B. Landman, and D. S. Bell Functional Characteristics of Commercial Ambulatory Electronic Prescribing Systems: A Field Study J. Am. Med. Inform. Assoc., May 1, 2005; 12(3): 346 - 356. [Abstract] [Full Text] [PDF]

				A.-M. J. Audet, M. M. Doty, J. Shamasdin, and S. C. Schoenbaum Measure, Learn, And Improve: Physicians' Involvement In Quality Improvement Health Aff., May 1, 2005; 24(3): 843 - 853. [Abstract] [Full Text] [PDF]

				C. J. Stille, A. Jerant, D. Bell, D. Meltzer, and J. G. Elmore Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice Ann Intern Med, April 19, 2005; 142(8): 700 - 708. [Abstract] [Full Text] [PDF]

				R. Cunningham Professionalism Reconsidered: Physician Payment In A Small-Practice Environment Health Aff., November 1, 2004; 23(6): 36 - 47. [Abstract] [Full Text] [PDF]