Development of a end-user needs assessment instrument to improve efficacy of EMR implementation

Beyond complete health care reform, advances in technology within health care services are seen as one of the primary strategies to improving quality and controlling costs. The diffusion of the electronic medical record (EMR) within health care settings holds considerable promise in achieving the quality assurance goals of the IOM, as well as managing costs. However, adoption of EMRs within medical organizations has been slow over the last decade, with only about 20-25% of US hospitals in 2005 either using or developing EMRs (Ash, et al., 2004; Bert, et al., 2005; Fonkych & Taylor, 2005). One of the factors related to slow diffusion is the significant initial failure rates in EMR implementation. It is estimated that up to 80% of initial attempts at EMR implementation are met with failure (Brailer, 2004). While attention has been given to software and hardware issues, the majority of failures can be attributed to organizational resistance, ineffective change management, and lack of sufficient technical support and assistance to end users (i.e., clinical staff). This presentation describes the development of a EMR needs assessment instrument designed to help efficacy of the implementation process. The EMR needs assessment instrument was administered to end users at a regional medical center in the northeast. Using a varimax factor analytic method, four main factors were identified: 1) Quality Assurance and Improving Patient Outcomes; 2) EMR Connectivity and Data Access; 3) Physician Orders, Electronic Referral and Scheduling; and 4) Patient Records and Report Summaries. Numerous significant differences existed when comparing demographic characteristics of end users across the summated scores within the factor dimensions. The results are discussed in the context of organizational change management, staff supports, and targeting technical assistance efforts in EMR implementation.