Some of the physicians used the electronic health records as a means for collaboration to share the

screen with their patients. They showed them some pictures to illustrate and explain concerns. System-dependent factors A summary of the advantages and barriers highlighted by physicians using the EMR is discussed in the text below. The kinase inhibitor Tofacitinib quality of documentation Physicians believed that the EMR improved the quality and clarity of the documentation, for example, “it is very helpful, very readable, better than the handwriting”; another example, “previously they were usually write their own abbreviations ‘LE’, ‘RE’ not sure what they mean is it LEFT EYE or the disease itself but now because of the system coding they tend to write” (FG2). However, some physicians described the system as complex and less informative, for example, “if the doctor is free texting he will say the real thing and when you read

it you will know what is the meaning exactly (overlapping talk) but if you tick tick, tick sometime you lose” (FG3). Participants in all focus groups agreed that the current EMR was designed mainly for the hospitals and not for the primary care centres, for example, “The system was not designed for primary care (all agree) it is designed for hospitals this is the main issue for us” (FG3). Physicians had difficulties finding a diagnosis for some of the common conditions like skin laceration or skin abrasion seen in daily practices. System complexity and interconnectivity A common theme was the complexity of the system. Participants explained that they had difficulty at the beginning of implementation of the system to find the proper coding for the diagnosis. They also reported that sometimes they had to duplicate and repeat notes in several locations because there was no link, for example, between the notification system and the patient notes, for example, “Notification system, there must be a connection between Health Authority Abu Dhabi and cerner (EMR) another thing some cases…if anyone experience how to notify a case of syphilis he will hate himself

(laughing). Four pages you must fulfill four (4) pages” (FG3). Participants were very satisfied with the pre-completed notes in the system. They mentioned that it helped them save time and was very useful in the GSK-3 specialty clinics, for example, “Definitely, it saves a lot of time” (FG1); another example, “Helpful, especially in the clinics, the specialized clinics like the well-baby clinic, in antenatal clinic, in chronic clinic” (FG1). They also emphasised that in the long run the review of accumulated documentation will be challenging by asserting that visual scanning is impossible without highlights, for example, “Accumulation over the year will be a problem because you cannot go through all the note to find something” (FG1).