Critical success factors for electronic medical records access by primary health care professionals : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Information Systems at Massey University

Abstract

Electronic medical records (EMRs) are increasingly used in health care. Their successful use will result in improving the efficient integration of primary and secondary care, one of the main strategies of the current health reforms in New Zealand. Some secondary health care institutions in New Zealand are considering implementing an EMR that will be located within the secondary health care institution but that could be accessed by primary health care professionals. The purpose of this research project was to identify the critical success factors for access by primary health care professionals, who may not be employees of the secondary health care institution, to such an EMR. The research project utilised a variety of data collection methodologies. A literature review identified published primary and secondary health care requirements. A postal survey of GPs, midwives and specialist obstetricians working in primary care within a Crown Health Enterprise (CHE) catchment area was conducted. The literature review enabled the development of a critical success model based on the Technology Acceptance Model which was supported by the results of the primary care survey. The findings of this research project indicate that critical success factors for EMR access include user acceptance of the EMR, perceived usefulness of an EMR that is easy to use, ensuring privacy, security and confidentiality of data, obtaining patient consent, and the use of data and communication standards. The concerns of all the users of an EMR have a significant impact on the success of an EMR system implementation in a secondary care health care institution that can be accessed by primary care health professionals. If these concerns are not met, use of the system will be limited, the benefits of such a system will not materialise and the implementation project will not be successful. This research project recommends that further research is undertaken to explore the concerns of patients regarding the access to and use of EMRs.