Insights from User Requirements on Electronic Health Record (EHR) System Transition: A Mixed-Method Retrospective Study

Background Since the 2003 revision of the Medical Service Act, the adoption of Electronic Health Record (EHR) systems has steadily increased in South Korea, with most hospitals and clinics implementing these systems by 2020. This study aimed to explore strategies to reduce challenges, costs, and time associated with EHR system transitions by analyzing the user requirements that arise during the transition from one EHR system to another at Hospital B, a general hospital with 835 beds. Methods This study analyzed 5,117 unique user requirements collected through interviews with hospital staff. Requirements were categorized by task (clinical care, ancillary services, revenue cycle management, and enterprise resource planning) and reason (ease of use, patient care, hospital-specific processes, and national policies). The study also analyzed the customization rate, which is defined as the proportion of user requirements customized compared with those that were not. Statistical analyses were performed using the Chi-square test. Results There was a statistically significant difference in the customization rate according to task categorization and reasons for user requirements. When user requirements were categorized according to task categorization, the customization rates were lower for clinical care and ancillary services. Conversely, customization rates were higher for revenue cycle management and enterprise resource planning. When categorized by the reasons for user requirements, customization rates were lower for ease of use and patient care. In contrast, the customization rates were higher for hospital-specific processes and national policies. Conclusions It was found that requirements related to administrative tasks and specific causes tended to require higher levels of customization. In contrast, requirements related to patient care and general causes are more likely to reduce the degree of customization through sufficient explanation and consensus. Given the varying customization rates across task categories and the reasons for user requirements, adopting a tailored approach for each category, such as emphasizing thorough explanations for patient care and adapting to unique hospital processes for administrative tasks, can help reduce the costs and time required for EHR system transitions. Trial Registration: Not applicable.