5.1.2. System features to support challenging users
In addition to the complex setting at SN other factors related to
the work staff complicated the adoption of the system. Users had
rejected previous versions of the system and many of them lacked
IT skills. These are highly relevant issues when designing EMR systems
in both developing and developed countries. Studies of EMR
systems in the developed world have noted a lack of computing
skills as a specific issue which can lead to system failure [15].
The high failure rate of MI systems due to user and staff resistance
[8] also suggests that projects will often be conducted in a context
where users have previously rejected systems. The success at SN in
dealing with such a user group gives a concrete example of how in
some contexts it is possible to overcome these challenges. Some
specific (technical and social) features of the EMR system design
at SN can serve as starting points when considering how to meet
organizational and user needs in similar environments (including
skeptical users and those lacking IT skills) in both developing and
developed countries. These include: