93 Medical Specialists’ Perspectives on the Influence of Electronic Medical Record Use participants. As explained in the methods paragraph, the ‘change process’ aspect is of particular interest from a systems perspective, and it will be treated last to reflect on possible future developments. Participating hospitals included two academic hospitals, four teaching hospitals and five local hospitals (see also table 1, 3). However, based on hospital type, no difference was found between participants’ observations. The availability of nursing documentation and of the CLMA and advanced CDSS in the hospital concerned did not lead to differences (see also table 1, 3) in the experiences of the medical specialists. The technical aspects During the interviews, this was the category all medical specialists chose to talk about first. It therefore seems like medical specialists consider it the most important factor influencing EMR use in the hospital. To provide more insight, the related tables include a subdivision of the technical aspects, followed by quotes from participants to illustrate what is meant with the more abstract terms of the model. A complete list of all quotes is available from the first author. Customisability Within the category ‘technical’, ‘customisability’ [table 4] is mentioned most often, more often as ‘barrier’ than as ‘facilitator’. The medical specialist compares the EMR systems in the hospital with the intelligent systems that can be used at home to buy a book or book a trip. It seems as though an administrative systemhas simply been converted into a medical system point-blank. 6
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