What engagement strategies are useful in facilitating the implementation of electronic health records in health care settings? A rapid review of qualitative evidence synthesis using the normalization process theory.

Journal: Digital health

Volume: 10

Issue: 

Year of Publication: 

Affiliated Institutions:  Centre for Health Policy (CHP), Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa. Medical School, University of Warwick, Warwick, UK.

Abstract summary 

The study aimed to identify and describe the engagement strategies used in implementing electronic health records in health care settings and to ascertain why they were successful or not, using normalization process theory.In this rapid review, we searched PubMed and CINAHL for qualitative and mixed methods primary studies published from 2010 to 2023 (June). We identified 41 studies that explored the implementation of EHRs, involving clinicians as participants. For quality appraisal, we employed the standards for reporting qualitative research (SRQR) tool. For analysis, a qualitative comparative analysis, using the normalization process theory was conducted. This was followed by a narrative synthesis to compile and analyze key findings.About 56% ( = 23) of the studies were conducted in hospitals, while the remaining were done in mental health, maternity, and ambulatory care settings. Participants included a range of clinicians such as nurses, physicians, doctors, dentists, pediatricians and other specialists. Evidence shows that prior to implementation, effective communication of the vision of EHRs and early user involvement in decision-making are useful engagement strategies in preparing users for implementation. Tailored training and on-demand technical support for users sustain system usage during the roll out. Lastly, ongoing engagement with users is essential for continuous user support and system improvements.User engagement improves the chances of successful implementation, particularly if engagement strategies are effective for the specific stages of implementation. The success of these strategies is more evident when they ensure normalization process theory tenets, which include user coherence, cognitive participation, collective action and reflective monitoring.

Authors & Co-authors:  Zharima Campion C Mhlanga Samantha S Abdulla Saira S Goudge Jane J Griffiths Frances F

Study Outcome 

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Statistics
Citations :  Ayatollahi H, Mirani N, Haghani H. Electronic health records: what are the most important barriers? Perspect Health Inf Manag 2014; 11(Fall).
Authors :  5
Identifiers
Doi : 20552076241291286
SSN : 2055-2076
Study Population
Male,Female
Mesh Terms
Other Terms
User engagement;electronic health records;healthcare setting;hormalization process theory;implementation;qualitative;rapid review
Study Design
Narrative Study
Study Approach
Qualitative,Mixed Methods
Country of Study
Mali
Publication Country
United States