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South Med J. 2010 Nov;103(11):1115-8. doi: 10.1097/SMJ.0b013e3181f69add.

A comparison of the adoption of electronic health records in North Carolina and South Carolina HIV systems.

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Duke Health Inequalities Program, Duke University Center for Health Policy, Durham, NC 27705, USA.



The electronic exchange of health records has been a notable topic in recent years in the effort to improve the quality of healthcare delivery and reduce administrative burden. Interviews and documents from stakeholders in human immunodeficiency virus (HIV) care, and HIV information technology were collected between November 2004 through March 2005 to conduct a qualitative policy analysis on the adoption of an electronic health record (EHR) system among HIV care providers in North Carolina and South Carolina.


Interview data on the current state of EHR use were collected in February through June 2008. The case study analysis included description, categorical aggregation, and naturalistic generalization.


Naturalistic generalizations that emerged were (1) state-level policies can have a significant effect on successful adoption of EHRs; (2) state-level champions are integral to cross-sectoral, multi-institutional EHR adoption; (3) voluntary and mandatory adoption strategies can lead to successful cross-sectoral, multi-institutional EHR implementation.


State health departments can play an integral part in the successful implementation of EHR systems.

[Indexed for MEDLINE]

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