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Leading change: introducing an electronic medical record system to a paramedic service

Shawn Baird (Portland, Oregon, USA)
George Boak (York St John University, York, UK)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 1 January 2016




Leaders in health-care organizations introducing electronic medical records (EMRs) face implementation challenges. The adoption of EMR by the emergency medical and ambulance setting is expected to provide wide-ranging benefits, but there is little research into the processes of adoption in this sector. The purpose of this study is to examine the introduction of EMR in a small emergency care organization and identify factors that aided adoption.


Semi-structured interviews with selected paramedics were followed up with a survey issued to all paramedics in the company.


The user interfaces with the EMR, and perceived ease of use, were important factors affecting adoption. Individual paramedics were found to have strong and varied preferences about how and when they integrated the EMR into their practice. As company leadership introduced flexibility of use, this enhanced both individual and collective ability to make sense of the change and removed barriers to acceptance.

Research limitations/implications

This is a case study of one small organization. However, there may be useful lessons for other emergency care organizations adopting EMR.

Practical implications

Leaders introducing EMR in similar situations may benefit from considering a sense-making perspective and responding promptly to feedback.


The study contributes to a wider understanding of issues faced by leaders who seek to implement EMRs in emergency medical services, a sector in which there has been to date very little research on this issue.



The authors would like to thank the anonymous reviewers for their constructive comments, which have helped to develop this paper.


Baird, S. and Boak, G. (2016), "Leading change: introducing an electronic medical record system to a paramedic service", Leadership in Health Services, Vol. 29 No. 2, pp. 136-150.



Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited

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