{"id":"https://openalex.org/W2995311420","doi":"https://doi.org/10.1055/s-0039-3402450","title":"An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework","display_name":"An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework","publication_year":2019,"publication_date":"2019-10-01","ids":{"openalex":"https://openalex.org/W2995311420","doi":"https://doi.org/10.1055/s-0039-3402450","mag":"2995311420","pmid":"https://pubmed.ncbi.nlm.nih.gov/31853937"},"language":"en","primary_location":{"id":"doi:10.1055/s-0039-3402450","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0039-3402450","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0039-3402450.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0039-3402450.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5065985720","display_name":"Wendy Kiepek","orcid":null},"institutions":[{"id":"https://openalex.org/I2802377633","display_name":"Office of the National Coordinator for Health Information Technology","ror":"https://ror.org/02fm3sv87","country_code":"US","type":"government","lineage":["https://openalex.org/I1299022934","https://openalex.org/I2802377633"]},{"id":"https://openalex.org/I901861585","display_name":"Vanderbilt University Medical Center","ror":"https://ror.org/05dq2gs74","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210162197","https://openalex.org/I901861585"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Wendy Kiepek","raw_affiliation_strings":["Health Information Technology (HealthIT), Vanderbilt University Medical Center, Nashville, Tennessee, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Information Technology (HealthIT), Vanderbilt University Medical Center, Nashville, Tennessee, United States","institution_ids":["https://openalex.org/I901861585","https://openalex.org/I2802377633"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5111859853","display_name":"Patricia P. Sengstack","orcid":null},"institutions":[{"id":"https://openalex.org/I200719446","display_name":"Vanderbilt University","ror":"https://ror.org/02vm5rt34","country_code":"US","type":"education","lineage":["https://openalex.org/I200719446"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Patricia P. Sengstack","raw_affiliation_strings":["School of Nursing, Vanderbilt University, Nashville, Tennessee, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Nursing, Vanderbilt University, Nashville, Tennessee, United States","institution_ids":["https://openalex.org/I200719446"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":1.9088,"has_fulltext":true,"cited_by_count":14,"citation_normalized_percentile":{"value":0.89513852,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":98},"biblio":{"volume":"10","issue":"05","first_page":"964","last_page":"971"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.6323999762535095,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.6323999762535095,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.04960000142455101,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11744","display_name":"Health Sciences Research and Education","score":0.04190000146627426,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/pdca","display_name":"PDCA","score":0.7347476482391357},{"id":"https://openalex.org/keywords/process-management","display_name":"Process management","score":0.5525144934654236},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.49826884269714355},{"id":"https://openalex.org/keywords/end-user","display_name":"End user","score":0.48861223459243774},{"id":"https://openalex.org/keywords/knowledge-management","display_name":"Knowledge management","score":0.4609963893890381},{"id":"https://openalex.org/keywords/system-administrator","display_name":"System administrator","score":0.43336570262908936},{"id":"https://openalex.org/keywords/information-system","display_name":"Information system","score":0.4228406846523285},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.416968435049057},{"id":"https://openalex.org/keywords/quality-management","display_name":"Quality management","score":0.33152225613594055},{"id":"https://openalex.org/keywords/management-system","display_name":"Management system","score":0.29674261808395386},{"id":"https://openalex.org/keywords/operations-management","display_name":"Operations management","score":0.20108944177627563},{"id":"https://openalex.org/keywords/business","display_name":"Business","score":0.16897743940353394},{"id":"https://openalex.org/keywords/world-wide-web","display_name":"World Wide Web","score":0.15489935874938965},{"id":"https://openalex.org/keywords/engineering","display_name":"Engineering","score":0.12448927760124207}],"concepts":[{"id":"https://openalex.org/C66882329","wikidata":"https://www.wikidata.org/wiki/Q820214","display_name":"PDCA","level":4,"score":0.7347476482391357},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.5525144934654236},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.49826884269714355},{"id":"https://openalex.org/C91262260","wikidata":"https://www.wikidata.org/wiki/Q528074","display_name":"End user","level":2,"score":0.48861223459243774},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.4609963893890381},{"id":"https://openalex.org/C2780814629","wikidata":"https://www.wikidata.org/wiki/Q327353","display_name":"System administrator","level":2,"score":0.43336570262908936},{"id":"https://openalex.org/C180198813","wikidata":"https://www.wikidata.org/wiki/Q121182","display_name":"Information system","level":2,"score":0.4228406846523285},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.416968435049057},{"id":"https://openalex.org/C71405471","wikidata":"https://www.wikidata.org/wiki/Q757012","display_name":"Quality management","level":3,"score":0.33152225613594055},{"id":"https://openalex.org/C198783460","wikidata":"https://www.wikidata.org/wiki/Q629173","display_name":"Management system","level":2,"score":0.29674261808395386},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.20108944177627563},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.16897743940353394},{"id":"https://openalex.org/C136764020","wikidata":"https://www.wikidata.org/wiki/Q466","display_name":"World Wide Web","level":1,"score":0.15489935874938965},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.12448927760124207},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C38652104","wikidata":"https://www.wikidata.org/wiki/Q3510521","display_name":"Computer security","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C119599485","wikidata":"https://www.wikidata.org/wiki/Q43035","display_name":"Electrical engineering","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000046","descriptor_name":"Academic Medical Centers","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000046","descriptor_name":"Academic Medical Centers","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000046","descriptor_name":"Academic Medical Centers","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001292","descriptor_name":"Attitude to Computers","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001292","descriptor_name":"Attitude to Computers","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001292","descriptor_name":"Attitude to Computers","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1055/s-0039-3402450","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0039-3402450","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0039-3402450.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},{"id":"pmid:31853937","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/31853937","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied clinical informatics","raw_type":null}],"best_oa_location":{"id":"doi:10.1055/s-0039-3402450","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0039-3402450","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0039-3402450.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.49000000953674316,"id":"https://metadata.un.org/sdg/17","display_name":"Partnerships for the goals"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320313998","display_name":"Vanderbilt University Medical Center","ror":"https://ror.org/05dq2gs74"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W2995311420.pdf","grobid_xml":"https://content.openalex.org/works/W2995311420.grobid-xml"},"referenced_works_count":10,"referenced_works":["https://openalex.org/W1977488000","https://openalex.org/W2029128047","https://openalex.org/W2097180921","https://openalex.org/W2109257953","https://openalex.org/W2155857546","https://openalex.org/W2156805610","https://openalex.org/W2157842930","https://openalex.org/W2171733484","https://openalex.org/W2775269990","https://openalex.org/W2944107102"],"related_works":["https://openalex.org/W60017553","https://openalex.org/W1577349393","https://openalex.org/W2035843532","https://openalex.org/W2364714228","https://openalex.org/W2808987603","https://openalex.org/W4240748700","https://openalex.org/W2578388440","https://openalex.org/W2384712243","https://openalex.org/W2383875357","https://openalex.org/W2373293182"],"abstract_inverted_index":{"BACKGROUND:":[0],"Electronic":[1],"health":[2,106,207],"record":[3],"(EHR)":[4],"system":[5,96,162],"implementation":[6,21,52,102],"is":[7,177],"complex.":[8],"Strong":[9],"support":[10,41,94,119,144,156],"for":[11,71,127],"clinicians":[12],"and":[13,25,34,43,58,64,88,113,132,165,223],"other":[14,206],"end-users":[15],"during":[16,46,99],"the":[17,47,69,78,82,150],"initial":[18,48],"phase":[19,49],"of":[20,50,61,84,117,122,130,152,170,180],"requires":[22],"dedicated":[23,186],"resources":[24,187],"commitment":[26],"to":[27,95,137,188,214],"ensure":[28],"a":[29,104,193],"smooth":[30],"transition,":[31],"reduce":[32],"frustration,":[33],"assist":[35],"in":[36,103,143],"adoption.":[37],"OBJECTIVES:":[38],"Evaluate":[39],"end-user":[40],"processes":[42],"personnel":[44,145,157],"employed":[45],"EHR":[51,101,161,171],"at":[53],"an":[54,100,133],"academic":[55],"medical":[56],"center":[57],"identify":[59],"facilitators":[60],"success,":[62],"challenges,":[63],"lessons":[65,224],"learned.":[66,225],"METHODS:":[67],"Using":[68],"model":[70],"improvement":[72],"framework,":[73],"this":[74,217],"case":[75],"report":[76],"describes":[77],"activities":[79],"that":[80,184],"follow":[81],"concepts":[83],"planning,":[85],"doing,":[86],"studying,":[87],"acting":[89],"(PDSA)":[90],"when":[91],"providing":[92],"on-site":[93],"end":[97,175],"users":[98,176],"complex":[105,182],"care":[107,208],"system.":[108],"RESULTS:":[109],"Strengths":[110],"included":[111,159],"engaged":[112],"supportive":[114],"leadership,":[115],"use":[116,121],"internal":[118],"personnel,":[120],"zone":[123],"leaders,":[124],"daily":[125],"huddles":[126],"effective":[128],"dissemination":[129],"information,":[131],"evaluation":[134],"survey":[135],"tool":[136],"provide":[138],"data":[139],"supporting":[140],"rapid":[141],"changes":[142],"allocation.":[146],"Challenges":[147],"primarily":[148],"surrounded":[149],"management":[151],"over":[153],"1,000":[154],"external":[155],"which":[158],"limited":[160],"knowledge,":[163],"scheduling,":[164],"transportation":[166],"logistics.":[167],"CONCLUSION:":[168],"Implementation":[169],"systems":[172],"continues.":[173],"Supporting":[174],"one":[178],"aspect":[179],"these":[181],"projects":[183],"require":[185],"manage":[189],"effectively.":[190],"Organizations":[191],"taking":[192],"more":[194],"proactive":[195],"approach,":[196],"based":[197],"on":[198,216],"learning":[199],"from":[200,205],"experiences,":[201],"as":[202,204],"well":[203],"organizations,":[209],"can":[210],"improve":[211],"their":[212],"ability":[213],"take":[215],"challenge":[218],"armed":[219],"with":[220],"best":[221],"practices":[222]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":4},{"year":2024,"cited_by_count":2},{"year":2023,"cited_by_count":1},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":2},{"year":2020,"cited_by_count":2}],"updated_date":"2026-05-21T06:26:12.895304","created_date":"2025-10-10T00:00:00"}