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As governments commit to national electronic health record (EHR) systems, there is increasing international interest in identifying effective implementation strategies. We draw on Coiera's typology of national programmes – 'top-down', 'bottom-up' and 'middle-out' – to review EHR implementation strategies in three exemplar countries: England, the USA and(More)
OBJECTIVES To describe and evaluate the implementation and adoption of detailed electronic health records in secondary care in England and thereby provide early feedback for the ongoing local and national rollout of the NHS Care Records Service. DESIGN A mixed methods, longitudinal, multisite, socio-technical case study. SETTING Five NHS acute hospital(More)
OBJECTIVES To evaluate the implementation and adoption of the NHS detailed care records service in "early adopter" hospitals in England. DESIGN Theoretically informed, longitudinal qualitative evaluation based on case studies. SETTING 12 "early adopter" NHS acute hospitals and specialist care settings studied over two and a half years. DATA SOURCES(More)
OBJECTIVE To understand the medium-term consequences of implementing commercially procured computerized physician order entry (CPOE) and clinical decision support (CDS) systems in 'early adopter' hospitals. MATERIALS AND METHODS In-depth, qualitative case study in two hospitals using a CPOE or a CDS system for at least 2 years. Both hospitals had(More)
OBJECTIVE We aimed to explore stakeholder views, attitudes, needs, and expectations regarding likely benefits and risks resulting from increased structuring and coding of clinical information within electronic health records (EHRs). MATERIALS AND METHODS Qualitative investigation in primary and secondary care and research settings throughout the UK. Data(More)
BACKGROUND Although the collection of patient ethnicity data is a requirement of publicly funded healthcare providers in the UK, recording of ethnicity is sub-optimal for reasons that remain poorly understood. AIMS AND OBJECTIVES We sought to understand enablers and barriers to the collection and utilisation of ethnicity data within electronic health(More)
OBJECTIVE To understand the evolving market of commercial off-the-shelf Computerized Physician Order Entry (CPOE) and Computerized Decision Support (CDS) applications and its effects on their uptake and implementation in English hospitals. METHODS Although CPOE and CDS vendors have been quick to enter the English market, uptake has been slow and uneven.(More)
OBJECTIVE To explore the reasons for enrolling, experiences of participating and reasons for remaining in a family-based, cluster randomised controlled trial of a dietitian-delivered lifestyle modification intervention aiming to reduce obesity in South Asians at high risk of developing diabetes. DESIGN Qualitative study using narrative interviews of a(More)
BACKGROUND Drug allergy represent an important subset of adverse drug reactions that is worthy of attention because many of these reactions are potentially preventable with use of computerised decision support systems. This is however dependent on the accurate and comprehensive recording of these reactions in the electronic health record. The objectives of(More)