Implementing EHRs can have unintended outcomes related to reporting quality measures. At a recent conference, executives at Texas Health Resources, a 12-hospital network, said they had to make a lot of cultural changes to deal with issues such as getting doctors to enter data into problem lists. "It's about a collaborative approach to the EHR and remembering that the EHR implementation is dynamic, so you have to keep the users engaged," one executive said.

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