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