scholarly journals Attitudes towards using electronic health records of patients with psoriasis and dermatologists: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Toni Maria Klein ◽  
Matthias Augustin ◽  
Natalia Kirsten ◽  
Marina Otten

Abstract Background Electronic health records (EHRs) offer various advantages for healthcare delivery, especially for chronic and complex diseases such as psoriasis. However, both patients’ and physicians’ acceptability is required for EHRs to unfold their full potential. Therefore, this study compares patients’ and physicians’ attitudes towards using EHRs in routine psoriasis care. Methods For the purpose of this study, a questionnaire was developed based on literature research and analyses of previously conducted focus groups. Participants completed either a paper-based or an electronic version of the questionnaire. Patient recruitment took place at an dermatological outpatient clinic and via several online pathways (patient associations, and social media). Physicians were recruited via a mailing list of a dermatological association and at a dermatological conference. Patients’ and physicians’ responses were compared using χ2 tests and Fisher’s exact tests. Results The study consisted of 187 patients and 44 dermatologists. Patients compared to physicians rated almost all potential EHR uses as significantly more important and expected significantly more potential benefits from EHRs. Conclusions Patients showed positive expectations towards using EHRs, whereas there was more scepticism in the physician sample. This aligns with previous findings. These differences illustrate the necessity to involve all stakeholders, especially patients and physicians, into the process of developing and implementing EHRs.

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029594 ◽  
Author(s):  
Concepción Violán ◽  
Quintí Foguet-Boreu ◽  
Sergio Fernández-Bertolín ◽  
Marina Guisado-Clavero ◽  
Margarita Cabrera-Bean ◽  
...  

ObjectivesThe aim of this study was to identify, with soft clustering methods, multimorbidity patterns in the electronic health records of a population ≥65 years, and to analyse such patterns in accordance with the different prevalence cut-off points applied. Fuzzy cluster analysis allows individuals to be linked simultaneously to multiple clusters and is more consistent with clinical experience than other approaches frequently found in the literature.DesignA cross-sectional study was conducted based on data from electronic health records.Setting284 primary healthcare centres in Catalonia, Spain (2012).Participants916 619 eligible individuals were included (women: 57.7%).Primary and secondary outcome measuresWe extracted data on demographics, International Classification of Diseases version 10 chronic diagnoses, prescribed drugs and socioeconomic status for patients aged ≥65. Following principal component analysis of categorical and continuous variables for dimensionality reduction, machine learning techniques were applied for the identification of disease clusters in a fuzzy c-means analysis. Sensitivity analyses, with different prevalence cut-off points for chronic diseases, were also conducted. Solutions were evaluated from clinical consistency and significance criteria.ResultsMultimorbidity was present in 93.1%. Eight clusters were identified with a varying number of disease values: nervous and digestive; respiratory, circulatory and nervous; circulatory and digestive; mental, nervous and digestive, female dominant; mental, digestive and blood, female oldest-old dominant; nervous, musculoskeletal and circulatory, female dominant; genitourinary, mental and musculoskeletal, male dominant; and non-specified, youngest-old dominant. Nuclear diseases were identified for each cluster independently of the prevalence cut-off point considered.ConclusionsMultimorbidity patterns were obtained using fuzzy c-means cluster analysis. They are clinically meaningful clusters which support the development of tailored approaches to multimorbidity management and further research.


Drug Safety ◽  
2015 ◽  
Vol 38 (7) ◽  
pp. 671-682 ◽  
Author(s):  
Artur Akbarov ◽  
Evangelos Kontopantelis ◽  
Matthew Sperrin ◽  
Susan J. Stocks ◽  
Richard Williams ◽  
...  

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Antonio Gimeno-Miguel ◽  
Mercedes Clerencia-Sierra ◽  
Ignatios Ioakeim ◽  
Beatriz Poblador-Plou ◽  
Mercedes Aza-Pascual-Salcedo ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Alotaibi ◽  
E Tolma ◽  
W Alali ◽  
D Alhuwail ◽  
S Aljunid

Abstract Introduction Electronic Health Records (EHR) help physicians make effective decisions in patient care. With limited research in this area in Kuwait, we sought to identify the factors that contribute to the current use and satisfaction of EHR in Kuwait. Methods This cross-sectional study took place in a public hospital in 2019. Three-hundred ten physicians were recruited through convenience sampling (response rate: 95%). The survey which was translated into Arabic, was self-administered and it contained 48 statements. The Technology Acceptance Model was used as the theoretical framework. The dependent variables were satisfaction with EHR and current use of EHR. The main independent variables were barriers of using the EHR, perceived level of ease for using EHR, and effect of EHR on the physicians' work. Descriptive analysis, followed by bivariate, multivariate linear regression adjusted for demographics were conducted. Results The study sample consisted of predominantly males (82%), non-Kuwaiti (84%), and of young age (42% were 30-39 years old). The majority of the participants (76%) were currently using the EHR system. The physicians' satisfaction with use of EHR system was moderate (Mean: 3.47, SD: 0.81, range 1.33-5). The EHR effect on the physicians' work was the most significant predictor of satisfaction (β = 0.491, p = 0.000), followed by the level of ease (β = 0.274, p = 0.000), and length of use of EHR (β = 0.100, p = 0.006). Perceptions of barriers was the strongest predictor of current use of EHR (β=-0. 417, p = 0.000), followed by level of ease (β = 0.227, p = 0.000) and quality of a related training (β = 0.195, p = 0.000). Conclusions In the promotion of EHR use and related satisfaction, making the use of EHR functions (e.g. registration of clinical notes) as easy as possible seems to be a key factor. Other factors to consider are removing the barriers physicians face, making the benefits of use of EHR visible, and ensuring a high quality related training. Key messages Most physicians in a Kuwaiti public hospital use the EHR system. Perceived barriers, effect of EHR on the physicians’ work, and user-friendly application of EHR are associated with satisfaction and EHR use.


Author(s):  
Toni Maria Klein ◽  
Matthias Augustin ◽  
Marina Otten

Abstract Background Electronic health records (EHRs) are promising tools for routine care. These applications might not only enhance the interaction between patient and physician but also support therapy management. This is crucial in complex and chronic conditions like psoriasis. However, EHRs can only unfold their full potential when being accepted by the users. Therefore, this study aims to analyse how EHRs should be designed for patients with psoriasis and to identify differences between patient subgroups. Methods We developed a questionnaire on the acceptability of EHRs based on literature research and results from focus groups. Participants completed a paper-based or electronic version of the questionnaire. We recruited participants at an outpatient clinic as well as online via patient associations and a social media platform. We analysed data using descriptive statistics and bivariate analyses applying Chi-square and Fisher’s exact test. Results The sample encompassed 187 patients with psoriasis. Data reveals that 84.4% of the participants can think of entering data into an EHR. Participants prefer entering data at home (72.2%) instead of entering data in the waiting room (44.9%) and using an own internet-ready device (laptop/computer: 62.6%; smartphone/tablet: 61.5%) instead of a provided device (46.0%). Altogether, 55.6% of participants would accept entering data on a monthly basis when this lasts between one and 10 minutes and further 27.8% would accept even longer lasting data entry. Data privacy is of great concern (e.g. patient should decide who has access to data: 96.7%). Subgroup analyses reveal differences with regard to age, educational level, burden due to psoriasis, number of internet activities, use of electronic questionnaires and mode of administration. Conclusion The high acceptance of entering data is favourable for the implementation of EHRs. The results suggest technical and structural recommendations: Differences between subgroups support the development of flexible EHRs encompassing a basic module, which is expandable with further add-ons, and compatible to different devices. Furthermore, involving patients by entering data into an EHR requires that physicians communicate open-mindedly with the patient and consider data throughout decision-making. Patients should remain owner of their own health data and decide about its processing.


2013 ◽  
Vol 04 (02) ◽  
pp. 225-240 ◽  
Author(s):  
S. Banerjee ◽  
R. Kaushal ◽  
L.M. Kern ◽  
Z. M. Grinspan

SummaryObjective: Efforts to promote adoption of electronic health records (EHRs) have focused on primary care physicians, who are now expected to exchange data electronically with other providers, including specialists. However, the variation of EHR adoption among specialists is underexplored.Methods: We conducted a retrospective cross-sectional study to determine the association between physician specialty and the prevalence of EHR adoption, and a retrospective serial cross-sectional study to determine the association of physician specialty and the rate of EHR adoption over time. We used the 2005–2009 National Ambulatory Medical Care Survey. We considered fourteen specialties, and four definitions of EHR adoption (any EHR, basic EHR, full EHR, and a novel definition of EHR sophistication). We used multivariable logistic regression, and adjusted for several covariates (geography, practice characteristics, revenue characteristics, physician degree).Results: Physician specialty was significantly associated with EHR adoption, regardless of the EHR definition, after adjusting for covariates. Psychiatrists, dermatologists, pediatricians, ophthalmologists, and general surgeons were significantly less likely to adopt EHRs, compared to the reference group of family medicine / general practitioners. After adjustment for covariates, these specialties were 44 – 94% less likely to adopt EHRs than the reference group. EHR adoption increased in all specialties, by approximately 40% per year. The rate of EHR adoption over time did not significantly vary by specialty.Conclusions: Although EHR adoption is increasing in all specialties, adoption varies widely by specialty. In order to insure each individual’s network of providers can electronically share data, widespread adoption of EHRs is needed across all specialties.Citation: Grinspan ZM, Banerjee S, Kaushal R, Kern LM. Physician specialty and variations in adoption of electronic health records. Appl Clin Inf 2013; 4: 225–240http://dx.doi.org/10.4338/ACI-2013-02-RA-0015


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