Electronic medical records
Barriers to acceptance by doctors
DOI:
https://doi.org/10.29193/RMU.36.2.6Keywords:
ELECTRONIC HEALTH RECORDS, TECHNOLOGICAL CHANGE, ELECTRONIC MEDICAL RECORD, RESISTANCE FACTORSAbstract
Implementation of electronic medical records (EMRs) in the health system constitutes a process of technological change. Substituting paper for electronic medical records implies the medical record is no longer the registration of information with a great sense of ownership by thy the physician and the institution, and it also brings in the integration of information, team work, multidisciplinariety , rules and norms that are not your own, widely distributed Access to it for different legal and legitimate purposes.
This study aims to identify the factors that may result in doctors being against the use of EMRs in a health care institution. We conducted a qualitative research by means of semi-structured interviews and intentionally defined a sample. The global anslysis of the interviews reveals the combination of different factors for resistance in each one of the professionals, the most well known being: interferences in the doctor–patient relationship, the greater demand of time at the start, fear of the unknown, inadequacy of the work system and interests of the health professionals.
Likewise, different kinds of technology users are identified: some have embraced it, others are obliged users and other choose not to use it.
In conclusion, some of the barriers may be directly modified from the project management, as for instance, the possibility of using the software available, or the impact of time. However, there are other barriers that imply changes in the behaviour of medical professionals that are usually connected to their values and beliefs, what makes interventions seeking change more complex.
References
(2) Mengíbar Torres M, Del Río Urenda S, Terol Fernández FJ. Gestión del cambio. En: Temes Montes JL, Mengíbar Torres M, eds. Gestión hospitalaria. España: McGraw-Hill Interamericana de España, 2013:501-23.
(3) Luna D, Soriano E, González Bernaldo de Quirós F. Historia clínica electrónica. Rev Hosp Ital B Aires 2007; 27(2):77-85.
(4) Toboso M. Entre el uso y no uso de la tecnología: un enfoque discursivo de la apropiación tecnológica. Intersticios 2013; 7(2):201-4.
(5) Ruiz Olabuénaga JI. El diseño cualitativo. En: Ruiz Olabuénaga JI. Metodología de la investigación cualitativa. 5ª ed. Bilbao: Universidad de Deusto, 2012:51-82.
(6) Luna D, Otero C, Plazzotta F, Campos F. Sistemas de información para la salud. Buenos Aires: Sociedad Italiana de Beneficencia en Buenos Aires, 2018.
(7) Dawidowsky AR, Toselli L, Luna DR, Oberti PF, Soto MA, González Bernaldo de Quirós F. Modificaciones en las perspectivas de los médicos sobre el registro médico electrónico: investigación cualitativa longitudinal. Gac Sanit 2007; 21(5):384-9.
(8) Boonstra A, Broekhuis M. Barriers to acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC Health Serv Res 2010; (10):1-17.
(9) Baum A, Luna D, Otero P, Schachner B, Montenegro S, Staccia G, et al. Rediseño de la gestión de la lista de problemas de una historia clínica electrónica utilizando la visión de usuarios. 2006 Disponible en: https://www.academia.edu/ 25281183/Rediseño_de_la_gestión_de_la_lista_de_problemas_de_una_historia_clínica_electrónica_utilizando_la_visión_de_los_usuarios [Consulta: 14 mayo 2019].
(10) Centro de Investigación y Documentación sobre problemas de la Economía, el Empleo y las Cualificaciones Profesionales. Valorizar el capital humano. Donostia/San Sebastián: CIDEC, 2000.(Cuadernos de trabajo, 30).
