Understanding health care providers' reluctance to adopt a national electronic patient record

An empirical and legal analysis

M. Zwaanswijk, M.C. Ploem, F.J. Wiesman, R.A. Verheij, R.D. Friele, J.K.M. Gevers

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background:
Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which eventually caused the Dutch government to stop its contribution to the national infrastructure.
Aim:
To explain Dutch health care providers' reluctance in adopting the n-EPR, we investigated their perceptions of problems associated with the n-EPR and their legal position regarding then-EPR. We hereby aim to provide suggestions about approaches that could promote successful implementation.
Methods:
The study consisted of two parts. The empirical part of the study was conducted in three health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, 17 stakeholders working in these organisations were interviewed to investigate health care providers' perceptions of problems associated with the n-EPR. In the legal part of the study, legal documents were analysed to study health care providers' legal position regarding the n-EPR and any associated problems.
Results:
The respondents expressed concerns about the confidentiality and safety of information exchange and the reliability and quality of patient data in the n-EPR, and indicated that their liability in case of medical errors was not sufficiently clear. The perceived problems could partly be attributed to legal uncertainties.
Conclusions:
It is recommended to start the implementation of an n-EPR in limited geographical areas. This will allow health care providers to experience benefits of electronic information exchange before being asked to participate in information exchange at a larger scale. The problems that health care providers perceive in the n-EPR should be minimised. Legislation underlying the n-EPR should provide sufficient clarity about health care professionals' responsibilities and liabilities.
Original languageEnglish
Pages (from-to)13-31
JournalMedicine and Law
Volume32
Issue number1
Publication statusPublished - 2013

Fingerprint

Health Personnel
electronics
health care
information exchange
legal position
Delivery of Health Care
liability
Organizations
Medical Errors
Legal Liability
Legislation
chronic illness
Mental Health
continuity
mental health
legislation
stakeholder
uncertainty
infrastructure
efficiency

Cite this

Zwaanswijk, M., Ploem, M. C., Wiesman, F. J., Verheij, R. A., Friele, R. D., & Gevers, J. K. M. (2013). Understanding health care providers' reluctance to adopt a national electronic patient record: An empirical and legal analysis. Medicine and Law, 32(1), 13-31.
Zwaanswijk, M. ; Ploem, M.C. ; Wiesman, F.J. ; Verheij, R.A. ; Friele, R.D. ; Gevers, J.K.M. / Understanding health care providers' reluctance to adopt a national electronic patient record : An empirical and legal analysis. In: Medicine and Law. 2013 ; Vol. 32, No. 1. pp. 13-31.
@article{22738fc51d0a488c961ad123914def9e,
title = "Understanding health care providers' reluctance to adopt a national electronic patient record: An empirical and legal analysis",
abstract = "Background:Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which eventually caused the Dutch government to stop its contribution to the national infrastructure.Aim:To explain Dutch health care providers' reluctance in adopting the n-EPR, we investigated their perceptions of problems associated with the n-EPR and their legal position regarding then-EPR. We hereby aim to provide suggestions about approaches that could promote successful implementation.Methods:The study consisted of two parts. The empirical part of the study was conducted in three health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, 17 stakeholders working in these organisations were interviewed to investigate health care providers' perceptions of problems associated with the n-EPR. In the legal part of the study, legal documents were analysed to study health care providers' legal position regarding the n-EPR and any associated problems.Results:The respondents expressed concerns about the confidentiality and safety of information exchange and the reliability and quality of patient data in the n-EPR, and indicated that their liability in case of medical errors was not sufficiently clear. The perceived problems could partly be attributed to legal uncertainties.Conclusions:It is recommended to start the implementation of an n-EPR in limited geographical areas. This will allow health care providers to experience benefits of electronic information exchange before being asked to participate in information exchange at a larger scale. The problems that health care providers perceive in the n-EPR should be minimised. Legislation underlying the n-EPR should provide sufficient clarity about health care professionals' responsibilities and liabilities.",
author = "M. Zwaanswijk and M.C. Ploem and F.J. Wiesman and R.A. Verheij and R.D. Friele and J.K.M. Gevers",
year = "2013",
language = "English",
volume = "32",
pages = "13--31",
journal = "Medicine and Law",
issn = "0723-1393",
publisher = "Yozmot Ltd",
number = "1",

}

Zwaanswijk, M, Ploem, MC, Wiesman, FJ, Verheij, RA, Friele, RD & Gevers, JKM 2013, 'Understanding health care providers' reluctance to adopt a national electronic patient record: An empirical and legal analysis', Medicine and Law, vol. 32, no. 1, pp. 13-31.

Understanding health care providers' reluctance to adopt a national electronic patient record : An empirical and legal analysis. / Zwaanswijk, M.; Ploem, M.C.; Wiesman, F.J.; Verheij, R.A.; Friele, R.D.; Gevers, J.K.M.

In: Medicine and Law, Vol. 32, No. 1, 2013, p. 13-31.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Understanding health care providers' reluctance to adopt a national electronic patient record

T2 - An empirical and legal analysis

AU - Zwaanswijk, M.

AU - Ploem, M.C.

AU - Wiesman, F.J.

AU - Verheij, R.A.

AU - Friele, R.D.

AU - Gevers, J.K.M.

PY - 2013

Y1 - 2013

N2 - Background:Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which eventually caused the Dutch government to stop its contribution to the national infrastructure.Aim:To explain Dutch health care providers' reluctance in adopting the n-EPR, we investigated their perceptions of problems associated with the n-EPR and their legal position regarding then-EPR. We hereby aim to provide suggestions about approaches that could promote successful implementation.Methods:The study consisted of two parts. The empirical part of the study was conducted in three health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, 17 stakeholders working in these organisations were interviewed to investigate health care providers' perceptions of problems associated with the n-EPR. In the legal part of the study, legal documents were analysed to study health care providers' legal position regarding the n-EPR and any associated problems.Results:The respondents expressed concerns about the confidentiality and safety of information exchange and the reliability and quality of patient data in the n-EPR, and indicated that their liability in case of medical errors was not sufficiently clear. The perceived problems could partly be attributed to legal uncertainties.Conclusions:It is recommended to start the implementation of an n-EPR in limited geographical areas. This will allow health care providers to experience benefits of electronic information exchange before being asked to participate in information exchange at a larger scale. The problems that health care providers perceive in the n-EPR should be minimised. Legislation underlying the n-EPR should provide sufficient clarity about health care professionals' responsibilities and liabilities.

AB - Background:Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which eventually caused the Dutch government to stop its contribution to the national infrastructure.Aim:To explain Dutch health care providers' reluctance in adopting the n-EPR, we investigated their perceptions of problems associated with the n-EPR and their legal position regarding then-EPR. We hereby aim to provide suggestions about approaches that could promote successful implementation.Methods:The study consisted of two parts. The empirical part of the study was conducted in three health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, 17 stakeholders working in these organisations were interviewed to investigate health care providers' perceptions of problems associated with the n-EPR. In the legal part of the study, legal documents were analysed to study health care providers' legal position regarding the n-EPR and any associated problems.Results:The respondents expressed concerns about the confidentiality and safety of information exchange and the reliability and quality of patient data in the n-EPR, and indicated that their liability in case of medical errors was not sufficiently clear. The perceived problems could partly be attributed to legal uncertainties.Conclusions:It is recommended to start the implementation of an n-EPR in limited geographical areas. This will allow health care providers to experience benefits of electronic information exchange before being asked to participate in information exchange at a larger scale. The problems that health care providers perceive in the n-EPR should be minimised. Legislation underlying the n-EPR should provide sufficient clarity about health care professionals' responsibilities and liabilities.

M3 - Article

VL - 32

SP - 13

EP - 31

JO - Medicine and Law

JF - Medicine and Law

SN - 0723-1393

IS - 1

ER -