Louis Raymond, Aude Motulsky, Gregory Vial, Mickaël Ringeval, Guy Paré
{"title":"引导公共卫生系统大规模实施电子健康档案:快速审查的经验教训和建议","authors":"Louis Raymond, Aude Motulsky, Gregory Vial, Mickaël Ringeval, Guy Paré","doi":"10.1177/14604582251347120","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> This review systematically synthesizes empirical evidence from past NEHR initiatives to identify critical gaps between knowledge and practice and provide actionable insights for policymakers, health IT leaders, and practitioners.<b>Materials and Methods:</b> A rapid review approach was employed, focusing on qualitative content analysis of empirical studies published between 2010 and 2024. The search covered the Scopus, PubMed, Medline, and CINAHL databases. A total of 24 studies met the eligibility criteria and were analyzed across key dimensions.<b>Results:</b> Our analysis reveals that successful NEHR implementation hinges on three interdependent factors: (1) Stakeholder engagement and governance-meaningful clinician involvement and adaptive leadership strategies are crucial for system adoption; (2) Institutional and cultural alignment-the tension between centralized mandates and local adaptation must be carefully managed; and (3) Technological and process standardization-balancing interoperability with customizability remains a persistent challenge. Notably, rigid top-down implementations often face resistance, whereas hybrid \"middle-out\" approaches tend to facilitate smoother transitions.<b>Conclusions:</b> NEHR deployments require a nuanced approach that integrates strategic decision-making, continuous stakeholder engagement, and flexible governance models. Policymakers and project leaders should prioritize participatory implementation strategies, adaptive standardization, and mechanisms for iterative learning to enhance the sustainability and effectiveness of these systems.</p>","PeriodicalId":55069,"journal":{"name":"Health Informatics Journal","volume":"31 2","pages":"14604582251347120"},"PeriodicalIF":2.3000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Navigating large-scale EHR implementations in public health systems: Lessons learned and recommendations from a rapid review.\",\"authors\":\"Louis Raymond, Aude Motulsky, Gregory Vial, Mickaël Ringeval, Guy Paré\",\"doi\":\"10.1177/14604582251347120\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> This review systematically synthesizes empirical evidence from past NEHR initiatives to identify critical gaps between knowledge and practice and provide actionable insights for policymakers, health IT leaders, and practitioners.<b>Materials and Methods:</b> A rapid review approach was employed, focusing on qualitative content analysis of empirical studies published between 2010 and 2024. The search covered the Scopus, PubMed, Medline, and CINAHL databases. A total of 24 studies met the eligibility criteria and were analyzed across key dimensions.<b>Results:</b> Our analysis reveals that successful NEHR implementation hinges on three interdependent factors: (1) Stakeholder engagement and governance-meaningful clinician involvement and adaptive leadership strategies are crucial for system adoption; (2) Institutional and cultural alignment-the tension between centralized mandates and local adaptation must be carefully managed; and (3) Technological and process standardization-balancing interoperability with customizability remains a persistent challenge. Notably, rigid top-down implementations often face resistance, whereas hybrid \\\"middle-out\\\" approaches tend to facilitate smoother transitions.<b>Conclusions:</b> NEHR deployments require a nuanced approach that integrates strategic decision-making, continuous stakeholder engagement, and flexible governance models. Policymakers and project leaders should prioritize participatory implementation strategies, adaptive standardization, and mechanisms for iterative learning to enhance the sustainability and effectiveness of these systems.</p>\",\"PeriodicalId\":55069,\"journal\":{\"name\":\"Health Informatics Journal\",\"volume\":\"31 2\",\"pages\":\"14604582251347120\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Informatics Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/14604582251347120\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Informatics Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/14604582251347120","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Navigating large-scale EHR implementations in public health systems: Lessons learned and recommendations from a rapid review.
Objective: This review systematically synthesizes empirical evidence from past NEHR initiatives to identify critical gaps between knowledge and practice and provide actionable insights for policymakers, health IT leaders, and practitioners.Materials and Methods: A rapid review approach was employed, focusing on qualitative content analysis of empirical studies published between 2010 and 2024. The search covered the Scopus, PubMed, Medline, and CINAHL databases. A total of 24 studies met the eligibility criteria and were analyzed across key dimensions.Results: Our analysis reveals that successful NEHR implementation hinges on three interdependent factors: (1) Stakeholder engagement and governance-meaningful clinician involvement and adaptive leadership strategies are crucial for system adoption; (2) Institutional and cultural alignment-the tension between centralized mandates and local adaptation must be carefully managed; and (3) Technological and process standardization-balancing interoperability with customizability remains a persistent challenge. Notably, rigid top-down implementations often face resistance, whereas hybrid "middle-out" approaches tend to facilitate smoother transitions.Conclusions: NEHR deployments require a nuanced approach that integrates strategic decision-making, continuous stakeholder engagement, and flexible governance models. Policymakers and project leaders should prioritize participatory implementation strategies, adaptive standardization, and mechanisms for iterative learning to enhance the sustainability and effectiveness of these systems.
期刊介绍:
Health Informatics Journal is an international peer-reviewed journal. All papers submitted to Health Informatics Journal are subject to peer review by members of a carefully appointed editorial board. The journal operates a conventional single-blind reviewing policy in which the reviewer’s name is always concealed from the submitting author.