Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective

•The implementation of EHR is a complex, challenging process.•The challenges lie both in the software practices and the overall management culture.•There is a mismatch between end-users and product owner/ vendor perspectives concerning EHR implementation success factors.•Coping with the complexity of implementation requires increased communication and horizontal collaboration.•A shift is required from pushing healthcare technology to using EHR for improving the working practice of clinical staff.

BackgroundElectronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics.ObjectivesThis article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context.MethodsWe used Grounded Theory to analyse data collected in the context of Brunei's national EHR − the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding.ResultsSix perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives.DiscussionWorkflow changes were significant challenges to clinicians' confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment.