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Factors Influencing Outcomes of Clinical Information Systems Implementation: A Systematic Review

GRUBER, DIANNE RN, MN; CUMMINGS, GRETA G. RN, PhD; LEBLANC, LISA RN, BN; SMITH, DONNA L. RN, BScN, MEd, RPsych, CHE

CIN: Computers, Informatics, Nursing:
doi: 10.1097/NCN.0b013e31819f7c07
Continuing Education
Abstract

Healthcare agencies spend significant resources to acquire or develop clinical information systems. However, implementation of clinical information systems often report significant failures. A systematic review of the research literature identified processes and outcomes of clinical information system implementation and factors that influenced success or failure. Of 124 original papers, 18 met the primary inclusion criteria-clinical systems implementation, healthcare facility, and outcome measures. Data extraction elements included study characteristics, outcomes, and implementation risk factors classified according to the Expanded Systems Life Cycle. The quality of each study was also assessed. Forty-nine outcomes of clinical information system implementation were identified. No single implementation strategy proved completely effective. The findings of this synthesis direct the attention of managers and decision makers to the importance of clinical context to successful implementation of clinical information systems. The highest number of factors influencing success or failure was reported during implementation and system "go-live." End-user support or lack thereof was the important factor in both successful and failed implementations, respectively. Following the Expanded Systems Life Cycle management model instead of a traditional project management approach may contribute to greater success over time, by paying particular attention to the underrecognized maintenance phase of implementation.

Author Information

Author Affiliations: Acute Care Clinical Applications Team, Information Systems, Alberta Health Services (Ms Gruber); Faculty of Nursing, University of Alberta, Alberta, Canada (Dr Cummings and Professor Smith); and A Division of Covenant Health, Grey Nuns Community Hospital, Edmonton, Alberta, Canada (Ms LeBlanc).

Disclaimer: Authors declare no conflict of interest.

Corresponding author: Greta G. Cummings, RN, PhD, Faculty of Nursing, University of Alberta, Clinical Sciences Building, 5-125 CSB, Edmonton, AB, Canada T6G2G3 (gretac@ualberta.ca).

© 2009 Lippincott Williams & Wilkins, Inc.