We investigated factors that could govern the use and user competence of electronic patient record (EPR) systems used in Finnish primary healthcare in the county of South Ostrobothnia. A structured questionnaire was sent to 400 health center (HC) staff (general practitioner, nurse, and clerical) from eight HCs. The questions dealt with Information Technology (IT) management, use, and potential problems with EPR and user EPR training within the HC. The response rate to the questionnaire was 79%. This study shows that there are large differences in working practices and in the way EPR systems are managed and utilized in the primary care organizations studied. A relatively high level of self-reported lack of competence in EPR use (21%) was indicated by the HC staff, clearly indicating that there is a need to improve user training. Results also indicate clear correlations between the incidence of user problems and whether there were routine procedures to disseminate best EPR user practices at the HC. If the HC had a clear IT development strategy, personnel were more likely to utilize the EPR system to develop the workflow and work practices of the HC. This study showed the importance of the EPR as a tool for a wide variety of tasks not restricted to patient data access. To improve and broaden the use of the EPR systems, more emphasis should be placed on IT management, support, training, and best practices
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