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Table 1 Macro, meso and micro factors affecting the implementation of EPRs

From: Implementing electronic patient record systems (EPRs) into England’s acute, mental health and community care trusts: a mixed methods study

Macro Meso Micro
Factor Description Factor Description Factor Description
National policy, and government influence Impact of NPfIT and impact of government targets that are not clinically focussed. Showing a return of investment Trusts are failing to show a return of investment. Business cases were rarely mentioned. Clinicians IT knowledge and willingness to be involved in IT projects Whether clinicians are engaged and/or adopt EPR systems can depend upon their IT skills and willingness to be involved.
Implementation strategies/solution strategies There is no single best approach to implementing EPRs available with trusts utilising a range of devices, systems and strategies when implementing EPRs. Finance and resources Trusts have varying finance and resources available despite being required to reach the same government targets. Clinician Involvement in EPR projects At an organisational level, whether trusts involve clinicians and how they involve them.
Technology and hardware available The technology available is not mature enough to meet clinical needs and to enable one device to be used for all tasks.    Managing Clinician expectations Clinicians often expect EPR projects to be completed or have high expectations of what can be achieved within the scope of EPR projects.