Perceived Barriers to the use of Electronic Health Records for Infectious Disease Surveillance in Canada

Abstract

This thesis examines the potential interface that exists between health information, specifically electronic health record (EHR) systems, and notifiable disease surveillance in Canada. It aims to highlight the benefits and barriers experienced by the current national notifiable disease surveillance strategy, as well as to highlight the successes and roadblocks to the successful implementation and adoption of EHR technologies in Canada. Qualitative methodologies, which include the 16 semi-structured interviews conducted with four key stakeholder groups, including public health experts, physicians, health administrators and academics that are concerned with EHR adoption and public health were used to obtain data. Data from interviews was analysed using grounded theory methodology and then verified using member checking and other data validation methods. Emergent themes from obtained data indicated that there is a large potential for the improvement of the current notifiable disease through the use of EHR technologies: however, the barriers currently faced by both the notifiable disease surveillance system and the state of implementation and adoption of EHR technologies prevent this from occurring. These barriers include political, financial, human, security/privacy, and technology barriers. Differences between stakeholder groups were explored, and potential solutions and insights into existing barriers were provided. The information gained from this study provides insight into the efficiency of the current infectious disease surveillance system and the progress of and need for the implementation of EHRs nationwide. In addition, the results of this study provide stakeholders with a deeper understanding of the barriers facing the use of EHR technologies for infectious disease surveillance and provide a starting place to address these issues. The results of this study can help to inform policy regarding public health surveillance and EHR implementation and adoption.