Study protocol

Users' perspectives of barriers and facilitators to implementing EHR in Canada: A study protocol

Marie-Pierre Gagnon^1,2 , Nicola Shaw³ , Claude Sicotte⁴ , Luc Mathieu⁵ , Yvan Leduc⁶ , Julie Duplantie¹ , James Maclean⁷ and France Légaré^1,6

¹  Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada

²  Department of Nursing, Université Laval, Québec, Canada

³  Faculty of Medicine, University of Alberta, Alberta, Canada

⁴  Department of Health Management, Université de Montréal, Montréal, Canada

⁵  Department of Nursing, Université de Sherbrooke, Québec, Canada

⁶  Department of Family Medicine, Université Laval, Québec, Canada

⁷  Innovation and Adoption Committee, Canada Health Infoway, Canada

author email corresponding author email

Implementation Science 2009, 4:20doi:10.1186/1748-5908-4-20

Published:	9 April 2009

Abstract

Background

In Canada, federal, provincial, and territorial governments are developing an ambitious project to implement an interoperable electronic health record (EHR). Benefits for patients, healthcare professionals, organizations, and the public in general are expected. However, adoption of an interoperable EHR remains an important issue because many previous EHR projects have failed due to the lack of integration into practices and organizations. Furthermore, perceptions of the EHR vary between end-user groups, adding to the complexity of implementing this technology. Our aim is to produce a comprehensive synthesis of actual knowledge on the barriers and facilitators influencing the adoption of an interoperable EHR among its various users and beneficiaries.

Methods

First, we will conduct a comprehensive review of the scientific literature and other published documentation on the barriers and facilitators to the implementation of the EHR. Standardized literature search and data extraction methods will be used. Studies' quality and relevance to inform decisions on EHR implementation will be assessed. For each group of EHR users identified, barriers and facilitators will be categorized and compiled using narrative synthesis and meta-analytical techniques. The principal factors identified for each group of EHR users will then be validated for its applicability to various Canadian contexts through a two-round Delphi study, involving representatives from each end-user groups. Continuous exchanges with decision makers and periodic knowledge transfer activities are planned to facilitate the dissemination and utilization of research results in policies regarding the implementation of EHR in the Canadian healthcare system.

Discussion

Given the imminence of an interoperable EHR in Canada, knowledge and evidence are urgently needed to prepare this major shift in our healthcare system and to oversee the factors that could affect its adoption and integration by all its potential users. This synthesis will be the first to systematically summarize the barriers and facilitators to EHR adoption perceived by different groups and to consider the local contexts in order to ensure the applicability of this knowledge to the particular realities of various Canadian jurisdictions. This comprehensive and rigorous strategy could be replicated in other settings.