Universität zu Köln

Dittmer, Kerstin ORCID: 0000-0003-3390-1377, Okumu, Mi-Ran ORCID: 0000-0002-9301-8829, Beckmann, Marina ORCID: 0000-0002-9826-3575, Cecon-Stabel, Natalia ORCID: 0000-0002-2548-5986, Di Gion, Paola ORCID: 0009-0008-0265-539X, Hansen, Till Jes ORCID: 0000-0001-6175-7670, Jaschke, Julia, Karbach, Ute ORCID: 0000-0003-3479-9474, Köberlein-Neu, Juliane, Nocon, Maya, Rusniok, Carsten ORCID: 0000-0002-5383-4549, Schmara, Jessica, Wurster, Florian ORCID: 0000-0001-5527-9238 and Pfaff, Holger ORCID: 0000-0001-9154-6575 (2025). “We are doing it together, don’t worry” – A qualitative study on the implementation of electronic medical records in German hospitals. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, 193. pp. 66-73. Elsevier. ISSN 1865-9217

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Abstract

Background: The ongoing implementation of electronic medical records (EMRs) in German hospitals is currently slow. Implementation science widely acknowledges the barriers and facilitators to implementation. Thus, specific preconditions are necessary to address the former and to support an effective EMR implementation. However, a lack of knowledge exists about these necessary preconditions in Germany. This study aims to gain insight into key stakeholders’ experiences with implementing EMR systems in German hospitals to identify preconditions for embedding EMRs in this social context. Methods: Expert interviews were conducted with members of hospital-wide implementation teams concerning EMR implementation. The interviewees belonged to the nursing, IT, medical, and pharmaceutical professions and worked in hospitals with different contextual characteristics. The interview guideline was based on the practical Consolidated Framework for Implementation, which supports the systematic assessment of potential barriers and facilitators to identify implementation strategies and necessary adaptations. Data was collected between May 2021 and September 2022, and the interviews were analyzed using qualitative content analysis. Results: Thirteen interviews were conducted with employees from eleven hospitals. Five critical preconditions emerged for EMR implementation based on our analysis: 1) adaptation, where the clinical context and EMRs are aligned; 2) stakeholder co-production, where all relevant stakeholders (e. g., professional groups, departments, and hierarchical levels) are involved in planning, implementing, and evaluating; 3) end-user participation, where end-users are involved in the implementation through close support and training; 4) integration into daily routines, where EMRs are integrated into daily work, including work processes that initially require additional effort but are necessary to experience the relative advantages; and 5) the continuous Plan-Do-Check-Act cycle, where the EMR implementation process is continuously reviewed and adjusted. In addition, activities to enact these preconditions were derived based on the interview data. Discussion: Our findings indicate that overall contextual adaptation is required. The five preconditions include essential activities to facilitate the integration of the EMR into daily routines. Participation, communication, and support are fundamental, as described in the international literature. Failure to comply with these preconditions can lead to challenges during implementation, such as end-user resistance. Conclusion: Considering social and technical aspects is paramount in implementing EMRs, which may also apply to future digital innovations’ change management processes.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Dittmer, Kerstin UNSPECIFIED https://orcid.org/0000-0003-3390-1377 UNSPECIFIED Okumu, Mi-Ran UNSPECIFIED https://orcid.org/0000-0002-9301-8829 UNSPECIFIED Beckmann, Marina UNSPECIFIED https://orcid.org/0000-0002-9826-3575 UNSPECIFIED Cecon-Stabel, Natalia UNSPECIFIED https://orcid.org/0000-0002-2548-5986 UNSPECIFIED Di Gion, Paola UNSPECIFIED https://orcid.org/0009-0008-0265-539X UNSPECIFIED Hansen, Till Jes UNSPECIFIED https://orcid.org/0000-0001-6175-7670 UNSPECIFIED Jaschke, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Karbach, Ute UNSPECIFIED https://orcid.org/0000-0003-3479-9474 UNSPECIFIED Köberlein-Neu, Juliane UNSPECIFIED UNSPECIFIED UNSPECIFIED Nocon, Maya UNSPECIFIED UNSPECIFIED UNSPECIFIED Rusniok, Carsten UNSPECIFIED https://orcid.org/0000-0002-5383-4549 UNSPECIFIED Schmara, Jessica UNSPECIFIED UNSPECIFIED UNSPECIFIED Wurster, Florian UNSPECIFIED https://orcid.org/0000-0001-5527-9238 UNSPECIFIED Pfaff, Holger UNSPECIFIED https://orcid.org/0000-0001-9154-6575 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-794343
Identification Number:	10.1016/j.zefq.2024.11.009
Journal or Publication Title:	Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
Volume:	193
Page Range:	pp. 66-73
Number of Pages:	8
Date:	April 2025
Publisher:	Elsevier
ISSN:	1865-9217
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft > Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft (IMVR)
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79434