• Ann Scheck McAlearney, Julie Robbins, Annemarie Hirsch, Maria Jorina, and J Phil Harrop.
• Division of Health Services Management and Policy, College of Public Health, Ohio State University, Columbus, OH 43210, United States. mcalearney.1@osu.edu
• Int J Med Inform. 2010 Dec 1; 79 (12): 807-16.

PurposeFaced with an increasingly complex patient population and growing demand for services, community health centers (CHCs) are recognizing that electronic health records (EHRs) may help their efforts to improve efficiency in care delivery. Yet little is known about the benefits, challenges, and specific impacts of EHR implementation in the often resource-constrained CHC environment, especially from users' perspectives. The objective of this study was to explore EHR users' perspectives about the EHR implementation process and impact in a CHC network.MethodsWe performed an exploratory case study following EHR implementation in a multi-site, urban CHC network. Data were collected through semi-structured interviews with 39 key informants across four sites. Key informants included physicians, clinical staff and administrators. We used both deductive and inductive approaches to code the transcribed interview data and to identify themes in our analyses.ResultsA key theme that emerged involved perceptions of efficiency related to the EHR implementation. While the EHR was widely credited with improving the efficiency of several clinical processes (e.g., lab ordering), it also created new challenges. Some of the early efficiency challenges we identified were common to EHR implementation in general (e.g., system interface issues), but others were unique to the CHC context (e.g., issues related to compliance with complex regulatory and reporting requirements). Further, constrained organizational resources for training and ongoing IT support were widely noted as challenges that may have exacerbated, or precluded early resolution of, efficiency issues. While limited to a single CHC network, our findings highlight important issues for CHCs to consider about EHRs.ConclusionsThese findings suggest that CHCs face difficult and often unique barriers related to EHR implementation and use, and the resultant efficiency impacts should not be overlooked.Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

12 keywords...

hide…