eHealth Observatory


Electronic Medical Record

Project: Formative Evaluation Study to Examine the Effects of Deploying a Physician Office EMR System on Patient Care
Status: Complete

This study was a formative evaluation study to examine the effects of deploying a physician office electronic medical record (EMR) system on patient care. This project was a collaborative effort between a team of health informatics researchers at the University of Victoria (UVic Team) and a physician community of practice in Interior BC. The objectives and scope of this study were to:

  1. Initiate a small-scale study for 6 months to explore the feasibility of engaging the community of practice to evaluate a new physician office EMR system that is currently being deployed in the community;
  2. Refine the EMR evaluation design and logistics so they are relevant to and feasible for the community of practice;
  3. Leverage this study as the foundation of a multi-year EMR evaluation proposal to seek external funding;
  4. Align with existing initiatives where feasible, such as the BC Medical Association (BCMA) hypertension guidelines, BC’s Physician Information Technology Office (PITO) program, Canadian Institute for Health Information’s  primary health care indicators project [1] and Infoway’s pan-Canadian EMR strategy;
  5. Address the question of “whether the adoption/use of a physician office EMR system can enhance practice performance, patient outcomes and overall satisfaction.” Our initial focus will be on the use of EMR in prescribing practice and hypertension (HTN) management.

This study used an action research oriented approach using the Rapid Response Evaluation Methodology (RREM) that we have developed at the UVic eHealth Observatory.  Our methods cover EMR benchmarking, usability engineering, productivity modeling, impact assessment and practice reflections. The study was a 6-month pre/post intervention design with assessment at month-1 and month-5. This work was funded through the College of Pharmacists of BC.


  1. Canadian Institute for Health Information. Primary Health Care Indicators EMR Content Standards, V 1.0. Ottawa, 2008.


Project: Post-Implementation Evaluation of an EMR in two BC clinics
Status: Complete

This study was a post-implementation evaluation of an EMR in two clinics in BC. The objectives of the study were to:

  1. Evaluate the adoption of the EMR at the two clinics to determine:
    a. What level of adoption has been acheived
    b. How this compares with similar clinics elsewhere
    c. What additional adoption lies ahead in these clinics
    d. What value is being delivered, qualitatively
    e. What barriers to adoption are present in these clinics
    f. What strategies could be employed to address those barriers
  2. Document lessons learned for future implementation
  3. Briefly propose a model for future evaluation of EMR rollout in the region

The study used several evaluation methods: surveys, interviews, usability/workflow scenarios, database queries, and focus groups. Participants included clinicians, managers and support staff at the two clinics, the EMR project team, and management.

A report was written at the completion of the study and given to the health authority in this region. This work was funded by Fraser Health. A follow-up evaluation is in the planning stages.


Project: Enhancing EMR Success in Primary Healthcare Settings
Status: Complete

The eHealth Observatory was asked to assess 5 clinics for their EMR adoption levels, train Manitoba eHealth staff on the methods and explore how and if our methods could be streamlined to be scalable to a provincial evaluation. Through this study we also developed connections with University of Manitoba's Department of Family Practice, in particular, were able to work with Dr. Alex Singer.

A report for Manitoba eHealth and a paper were produced. This work was funded through Manitoba eHealth.


Graduate Student Thesis: Understanding, evaluating and enhancing electronic medical record adoption in a primary care setting
Status: Complete

As part of his MSc degree program, Michael Bowen completed a study to explore the relationship between EMR adoption and chronic disease management incentives. His thesis is available here. This work was supported by the CIHR/Infoway eHealth Chair Award.