MedicalResearch: What is the background for this study? What are the main findings?
Dr. Sherer: With the growth in electronic health record implementation, there has been increasing demand for integration of these records within and across practice settings that have different work cultures, e.g. ambulatory and hospital locations. We find that computer integration alone does not result in coordination; users must value the integrated information and incorporate this information within their workflows. Users must move beyond technology acceptance and adaptation to focus on and value coordination. The system itself cannot drive these process changes; specific work process changes must be instituted and the users must adapt these changes.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Sherer: Simply implementing electronic health records and integrating information from disparate systems across different practice settings does not result in coordinated care. Significant work process changes will be required to effectively utilize this information. Implementation and integration of electronic health records systems is an evolutionary process that requires time and work practice change in order for clinicians to adjust, learn to trust the data, and incorporate coordination goals. During this evolution, as clinicians use the systems and begin to recognize their value for coordinated care, their views on the role of standardization and electronic health records for coordinated care must evolve.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Sherer: As clinicians begin to use electronic health record systems to coordinate across the continuum of care, we need further research and development of systems that can determine what information is most important and what needs to be integrated and presented at different specific points of care, reducing the burden on the clinicians to find the appropriate information. We also need research and development of more sophisticated tools that support care, not just care coordination, including improved decision support and practice guideline tools.
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