A Multi-Case Investigation of Electronic Health Record Implementation in Small- and Medium-Size Physician Practices

The American healthcare system has undergone significant changes as health information technology (HIT) has evolved. As part of the American Recovery and Reinvestment Act (ARRA), the Health Information Technology Economic and Clinical Health (HITECH) Act was created to incentivize the use of Health Information Technology (HIT) programs. While there have been multiple studies on HIT impact on large hospitals, very few studies address electronic health records (EHRs) within small- and medium-size physician practices (SMPPs). The two goals of this study are first to examine EHR implementation within SMPPs and provide recommendations on how to successfully implement an EHR system within a small practice, and secondly to examine the impact of EHR implementation on quality within the SMPP. For the five SMPPs and their implementation of EHR systems studied, findings show that, with sufficient training and appropriate use of a project champion, an SMPP can have a successful EHR implementation. Also shown are the different ways in which an EHR can positively impact an SMPP. This study promotes an understanding of how these small organizations tackle the challenges of implementing an EHR and provides practical guidelines for EHR implementation in SMPPs.