Implementation of clinical information systems is often difficult and costly. Little is known about how to implement electronic patient records in a complex dental school environment. The purpose of this study is to report how such a system was implemented at the University of Texas Health Science Center at Houston Dental Branch and to provide insights that may be useful for other institutions. To identify success factors and barriers, we reviewed project documents, interviewed key individuals on the implementation team, and surveyed end users before and after implementation. Eight critical issues were identified after extensive interviews with the project team. Surveys of students, faculty, and staff before and after implementation indicated that users had mixed feelings about the system in terms of efficiency and time required compared with paper charts. After using the system, many users felt that the electronic patient record improved patient care and that they would recommend such a system to dentists starting a new practice. By sharing lessons learned and knowledge about the science of implementation, we hope to reduce failures and costs for dental schools embarking on large-scale information technology implementations.

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