To systematically review studies assessing the effect of organizational factors on the effectiveness of EMR system implementation.

Research Methods
MEDLINE and reference lists of articles were searched for English-language articles published between 1990 and 2005. Studies assessing the effect of management support, financial resource availability, implementation climate and/or implementation policies and practices on the effectiveness of EMR system implementation were selected for inclusion in the review. Relevant data on study objective, study design, study population and setting, measures of implementation effectiveness and organizational factors, and key results were extracted and tabulated.

1,684 citations were identified through the search and 23 studies were found to be relevant to the objective of this study. Evidence was found to indicate organizational factors do influence the effectiveness of EMR system implementation and several themes are presented.

Numerous threats to the internal and external validity of the studies reviewed prevent generalizing and the development of any meaningful conclusions. Still, the results of this review can be taken at face value. For practitioners considering or about to begin an EMR system implementation, these results highlight the importance of considering organizational factors before, during and after EMR system implementation and represent a summary of lessons learned from early EMR adopters.


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    ElectronicHealthcare, 4(2) October 2005

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