Application of an EMR/EHR Needs Assessment Instrument in EMR Implementation

The Obama administration stimulus package includes a significant amount of funding to facilitate advancing technology within health care organizations. The diffusion of electronic medical records (EMRs) 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 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 has been the significant initial failure rates in EMR implementation. Between 50-80% of initial attempts at EMR implementation are met with failure (Brailer, 2004). While attention has been given to software/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 an EMR needs assessment instrument designed to improve the efficacy of the implementation process. This instrument was administered to 150 staff at a regional medical center in the northeast. Using a Varimax factor analytic method, five meaningful factors were identified: 1) “Increasing Efficiency While Reducing Errors”; 2) “Clinical Data Access and Connectivity”; 3) “Improving Patient Safety and Quality of Services”; 4) “Communication with Outside Organizations”; and 5) “Managing Diseases Across Healthcare Settings”. These five factors accounted for 70.3% of the cumulative variance. The authors provide examples of how various independent variables (i.e., occupation; years using a computer; previous EMR exposure, to name a few) can be used to determine if significant differences exist across the various factor dimensions. The results are discussed in the context of organizational change management, staff supports, and targeting technical assistance efforts in EMR implementation.