End-user support for primary care electronic medical records: a qualitative case study of users' needs, expectations, and realities

Support is considered an important factor for realizing the benefits of health information technology, but there is a dearth of research on the topic of support, especially in primary care. We conducted a qualitative multiple case study of four family health teams and one family health organization in Ontario, Canada in an attempt to gain insight into users' expectations and needs, and the realities of end-user support for primary care electronic medical records. Data were collected by semi-structured interviews, document review, and observation of training sessions. The analysis highlights the important role of on-site information technology staff and super-users in liaising with various stakeholders to solve technical problems and providing hardware and functional (how to) support; the local development of data support practices to ensure consistent documentation; and the gaps that exist in users' and support personnel's understanding of each other's work processes.