PURPOSE To study the number of disruptions in patient processes in a radiotherapy centre after the replacement of an Electronic Health Record (EHR), integrating information tools for patient care and billing. METHODS Our self-made Electronic Medical Record was replaced by a new EHR, including clinical path and workflow-management. A social-technological approach was used to reduce complexity. We measured disruptions in patient processes by the number and type of EHR related root causes and EHR-related incidents that reached patients, in our patient safety system 12 months before implementing the new EHR, 6 months after implementation (transition period) and 24 months after the transition period. We used Mann-Whitney U and X² tests to compare data before and after implementation. RESULTS An increase of disruptions occurred only temporarily during 6 months. After this period, the number stabilized to the level before implementation while having more functionalities and benefits. Neither the number nor the severity of incidents reaching patients increased. CONCLUSIONS Disruptions in patient processes are considered as a main barrier for implementing an EHR. Using a social/technical approach, the increase in disruptions did only temporarily occur and did not reach patients. We think it is important to share this insight with physicians because literature shows that their long-term opinion regarding the usefulness of the EHR is often based on the experience in the first months after implementation. Management of expectations is recommended. ADVANCES IN KNOWLEDGE This study is the first of its kind measuring long-term effects of EHR on patient processes in radiotherapy.

中文翻译：

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大型学术放射治疗部门实施电子病历：暂时中断但具有长期利益。

目的研究在更换电子健康记录（EHR）后放疗中心患者流程中断的次数，并集成了用于患者护理和计费的信息工具。方法我们将自己制作的电子病历替换为新的EHR，包括临床路径和工作流程管理。一种社会技术方法被用来减少复杂性。我们在实施新EHR之前12个月，实施6个月（过渡期）和实施24个月后的患者安全系统中，通过与EHR相关的根本原因和到达患者的EHR相关事件的数量和类型来衡量患者流程的中断。过渡期。我们使用了Mann-Whitney U和X²测试来比较实施前后的数据。结果中断的增加仅在6个月内临时发生。在此期间之后，该数量稳定到实施前的水平，同时具有更多的功能和优点。到达患者的事件的数量和严重性都没有增加。结论患者过程中的干扰被认为是实施电子病历的主要障碍。使用社交/技术方法，中断的增加只是暂时发生，没有到达患者。我们认为与医生分享这一见解很重要，因为文献表明，他们对EHR有用性的长期看法通常基于实施后头几个月的经验。建议管理期望。