Health IT

This is a really good and very broad question that many organizations are still figuring out. Even in developed countries, the rate of failure ie stopping to use a system or having it require much more cost and time to implement EMRs has been estimated to be between 30-60% by some authors.
The topics mentioned in original question are all really good points and usually a necessary part of implementing a system. My experience has been with implementing a laboratory reporting system for Tuberculosis to communicate lab results from regional labs to approximately 250 health centers in Lima, Peru. Here’s the article we wrote on our experience implementing the systems (http://www.biomedcentral.com/1472-6947/7/33).
What I wanted to highlight from the article where 3 things.
1. Having a local organization that has been on the ground working in the clinics or laboratories helped tremendously in being able to implement the information system there was already trust that our organization knew what it was doing and also the IT system was part of a larger project that had been on the ground for the last 2 years.
2. A local champion is key. We had a Peruvian ...

This is a really good and very broad question that many organizations are still figuring out. Even in developed countries, the rate of failure ie stopping to use a system or having it require much more cost and time to implement EMRs has been estimated to be between 30-60% by some authors.
The topics mentioned in original question are all really good points and usually a necessary part of implementing a system. My experience has been with implementing a laboratory reporting system for Tuberculosis to communicate lab results from regional labs to approximately 250 health centers in Lima, Peru. Here’s the article we wrote on our experience implementing the systems (http://www.biomedcentral.com/1472-6947/7/33).
What I wanted to highlight from the article where 3 things.
1. Having a local organization that has been on the ground working in the clinics or laboratories helped tremendously in being able to implement the information system there was already trust that our organization knew what it was doing and also the IT system was part of a larger project that had been on the ground for the last 2 years.
2. A local champion is key. We had a Peruvian clinician who knew how the system worked and who was the appropriate person to talk to in order to get and keep the project going.
3. Local appropriation of the system. In our case, this included putting a local name to the system (e-Chasqui, after the Incan runners), asking local clinicians and nurses their opinion about the system, and helping health centers when they had problems with the system or other things, such as internet or contacting the lab so that they would input a result.

There are many other factors, that I’m sure others can expand on, but these were the three most important for this implementation.

Joaquin

I have recently been involved with the implementation of an EMR at a local district hospital.
The system was initially meant to be used by doctors as they admit patients.
In terms of technical support,we had regular visits to the sites mostly preceeded by telephone calls to discuss pressing issues.
Among the things we had to do in order to encourage use of the system are:
1. Change the workflow to include nurses who were also very interested in using the system. Hence we had to design a portion of they system to suit these needs.

2. We had to appoint a champion(a clinician) at the hospital who would be the first contact person in case any issues arose. The champion would then contact us(developers) when there were issues that could not be resolved locally.

We are still in the process of learning more about the implementation experience and how we could make it more efficient in the event that we have to do it at another site.

Naomi