eHealth Observatory


EMR Evaluation Toolkit v3.0

Our rapid response methodology covers five electronic medical record (EMR) evaluation activities: adoption benchmarking, usability, productivity, impact assessment and practice reflection for knowledge translation (KT). Rapid response evaluation offers the breadth, depth and timeliness needed to address the entire EMR system lifecycle, multiple user/usage levels, incremental practice/outcome change, and capacity building. The evaluation activities are described below:

  1. EMR System - describes various means of capturing and defining EMR system functionality for use in studies that involve such systems;
  2. Impact Assessment – Conduct field evaluation studies to assess the impacts of EMR systems on physician performance, patient care/outcomes and physician/patient satisfaction. Suggested approaches include controlled trials, observational cohorts, surveys, data quality review and primary healthcare (PHC) indicators [2];
  3. EMR Adoption – Apply a conceptual EMR practice model to describe different EMR adoption/use scenarios based on adaptation of the HIMSS’ 5-stage EMR adoption model [1]. This allows us to determine the stage of EMR adoption/use in a given community of practice;
  4. Usability – Conduct usability studies to determine the usefulness/ease-of-use and optimal use of specific EMR systems and tasks for different users from novices to experts;
  5. Workflow Modeling – Examine physician office work process through workflow analysis and time-motion studies to determine current/optimal productivity patterns in specific tasks for the physician and support staff;
  6. Practice Reflection – Engage local communities of practice in building capacities by taking part in EMR evaluation studies, sharing lessons and fostering a culture of evidence-informed practice in ways that are self-sustaining.

The tools provided on this site have been developed to support the activities described above for evaluation studies. At this point, the tools are generally targeted towards ePrescribing, however the scope may be expanded as additional topics are addressed in our work. They can be used by analysts and researchers to perform evaluation studies or by clinicians for quality improvement purposes at their own practice.

Note that this is a "living" section in that the tools are work-in-progress and will evolve and be refined over time.

The tools are grouped into the same categories as above:

  1. EMR System: Tool for collecting information about the system itself in terms of the functionality, data elements, and data extraction.
  2. Impact Assessment: Includes a tool to assess impact on the user and another focused on assessing the process of implementing an EMR.
  3. EMR Adoption: A set of tools based on our five stage-model of EMR adoption which describes the characteristics of a practice at each stage of adoption.
  4. Usability: A set of tools for benchmarking and analyzing how the EMR is used to complete typical prescribing scenarios.
  5. Workflow Modeling: A set of tools based on our generic workflow for the prescribing process linked to the five stages of EMR adoption.
  6. Practice Reflection: Tools for gathering feedback after the study.

Release Notes for v3.0:

For our latest release, all tools from v2.0 (available here) were reviewed. The following tools were revised:

  • EMR Adoption Handbook
  • EMR Adoption Survey
  • ePrescribing Workflow Survey
  • ePrescribing Workflow Handbook
  • Practice Reflections Focus Group Script


  1. HIMSS and HIMSS Analytics. Electronic Medical Record Capabilities and Expected Benefits in US Non-federal Hospitals and Physician Clinics. Dec 17, 2008. URL:, Jun5/2009.
  2. Canadian Institute for Health Information. Primary Health Care Indicators EMR Content Standards, Version 1.0. Ottawa, 2008.