The Story Behind the Numbers: Best Practices for Adopting and Implementing Health IT

Emily Jones and Matthew Swain | September 19, 2013

There has been a dramatic increase in the adoption and use of electronic health records among healthcare providers and hospitals across the country.*  But the numbers don’t tell the whole story.  Behind the steep increase in electronic health record (EHR) adoption is the story of each provider and organization as they adopt and optimize health information technology (health IT).  What are the experiences of providers and organizations as they implement and optimize health IT?  Are there lessons and best practices to share with other organizations that might face similar obstacles?

Report details best practices for implementing health IT

A new ONC-funded report from the Urban Institute explores these questions by summarizing the findings of 75 articles that identify best and promising practices for implementing and optimizing health IT and electronic health records.  The report includes white papers as well as peer-reviewed articles and is unique since many literature reviews are limited to peer-reviewed journals, potentially omitting important information about the experiences of providers with adoption and meaningful use due to a publication bias favoring articles that use quantitative methods.

Health IT covers broad scope of activities

In addition to the planning, vendor selection, and implementation activities, there are three broad types of health IT activities that occur continuously:

  • workflow design and software customization
  • training and user support
  • optimization and modification

Successfully engaging in these health IT activities involves addressing different challenges from the technical, organizational, and personal perspectives.  The main findings include:

  • Staff at all levels should be engaged early and throughout the process of refining how technology is used throughout the organization.
  • Quality improvement should drive system requirements.
  • Planning for changes in user workflow is one of the first and most important tasks for organizations implementing an EHR system:  invest resources in workflow analysis so that workflows can be redesigned and the health IT customized for maximum benefit.
  • Ongoing workforce training and technical support are needed to maintain the system.
  • Leverage the skills of role models such as clinical leaders, champions, super-users, and training coordinators.

The importance of health IT

The Institute of Medicine considers health IT to be foundational as we strive to build a “learning health care system,” which uses evidence to improve quality, safety, and efficiency.  Harvesting and spreading best practices is critical to realizing the potential of a learning health care system.  To this end, health IT success stories are available on

Additional resources on implementing and optimizing health IT are also available on

*In addition to the ONC Data Briefs, there are two Health Affairs papers outlining the latest in hospital and ambulatory provider adoption, available with the 7/10 news clips on