scholarly journals The effectiveness of EMR implementation regarding reducing documentation errors and waiting time for patients in outpatient clinics: a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 514
Author(s):  
Salem Albagmi

Background: Electronic medical records (EMRs) refer to the digital copies of paper notes prepared in the physician’s office, outpatient clinics and other departments in health care institutes. EMRs are considered to be significant and preferable to paper records because they allow providers to keep accurate track of patient data and monitoring over time, thus reducing errors, and enhance overall health care quality. The aim of this systematic review was to highlight the significance of EMRs and the effectiveness of implementation regarding reducing documentation errors and waiting time for patients in outpatient clinics. Methods: PubMed, Central, Ovid, Scopus, Science Direct, Elsevier, Cochrane , WHO website and the McMaster University Health Evidence website from 2005-2020 were searched to identify studies that investigated the association between the EMR implementation and documentation error and waiting time for patients. A reviewer screened identified citations and extracted data according to the PRISMA guidelines and data was synthesized in a narrative manner. Results: After full text examination of the articles selected for this literature review, the major themes of relevance that were identified in the context of reducing documentation errors and waiting time for patients in outpatient clinic include: reduction of medical errors because of fewer documentation errors resulting from EMR implementation and reduction of waiting time for patients due to overall improvement of system workflow after use of EMRs. Conclusion: In summary of the reviewed evidence from published material, the implementation of an EMR system in any outpatient setting appears to reduce documentation errors (medication dose errors, issues of prescription errors). It was also seen that in many settings, waiting time for patients in outpatient clinics was reduced with EMR use, while in other settings it was not possible to determine if any significant improvement was seen in this aspect after EMR implementation.

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 514
Author(s):  
Salem Albagmi

Background: Electronic medical records (EMRs) refer to the digital copies of paper notes prepared in the physician’s office, outpatient clinics and other departments in health care institutes. EMRs are considered to be significant and preferable to paper records because they allow providers to keep accurate track of patient data and monitoring over time, thus reducing errors, and enhance overall health care quality. The aim of this systematic review was to highlight the significance of EMRs and the effectiveness of implementation regarding reducing documentation errors and waiting time for patients in outpatient clinics. Methods: PubMed, Central, Ovid, Scopus, Science Direct, Elsevier, Cochrane , WHO website and the McMaster University Health Evidence website from 2005-2020 were searched to identify studies that investigated the association between the EMR implementation and documentation error and waiting time for patients. A reviewer screened identified citations and extracted data according to the PRISMA guidelines and data was synthesized in a narrative manner. Results: After full text examination of the articles selected for this literature review, the major themes of relevance that were identified in the context of reducing documentation errors and waiting time for patients in outpatient clinic include: reduction of medical errors because of fewer documentation errors resulting from EMR implementation and reduction of waiting time for patients due to overall improvement of system workflow after use of EMRs. Conclusion: In summary of the reviewed evidence from published material, the implementation of an EMR system in any outpatient setting appears to reduce documentation errors (medication dose errors, issues of prescription errors). It was also seen that in many settings, waiting time for patients in outpatient clinics was reduced with EMR use, while in other settings it was not possible to determine if any significant improvement was seen in this aspect after EMR implementation.


2019 ◽  
Vol 21 (1) ◽  
pp. 71-77
Author(s):  
Hasan Abolghasem Gorji ◽  
Sanaz Royani ◽  
Mohammad Mohseni ◽  
Saber Azami-Aghdash ◽  
Ahmad Moosavi ◽  
...  

2019 ◽  
Vol 31 (10) ◽  
pp. G158-G164
Author(s):  
Eliza Lai-Yi Wong ◽  
Annie Wai-Ling Cheung ◽  
Richard Huan Xu ◽  
Carrie Ho-Kwan Yam ◽  
Sui-Fai Lui ◽  
...  

Abstract Objective The measurement of patients’ experience is an important performance indicator of health care service quality. A reliable and validated instrument to elicit patients’ experience is an important step. This study aimed to develop a generic instrument to elicit patients’ experience in specialist outpatient clinic provision with a rigorous and systematic methodology. Design The instrument framework was developed according to findings of a literature review, patient focus group discussions, individual patient in-depth interviews and expert discussion. The framework was tested for psychometric performance with a cross-sectional telephone survey in terms of practicality, validity, reliability and responsiveness. Setting 26 Public specialist outpatient clinics in Hong Kong were selected. Participants Cantonese speaking patients aged 18 or above. Intervention(s): None. Main outcome measure(s): A validated generic patient experience questionnaire measuring Specialist Outpatient Service (SOPEQ). Results A proportional sample total of 513 patients from 26 specialist outpatient clinics were recruited, response rate of 56%. The findings indicated that the instrument is practicable and concise. A structure of nine dimensions with 47 items structure was confirmed based on exploratory factor analysis and content validity. These items showed satisfactory internal reliability consistency (α = 0.793) and test–retest reliability ranged from 0.618 to 0.829. Conclusions The SOPEQ was established with satisfactory psychometric properties. A valid and reliable measure to evaluate patients’ experience is an important step in providing valuable input from patients’ perspective for policy makers to improve patient-centred services. It also serves as a platform to engage patients and thereby, in improving health care quality and enhancing health outcomes.


10.2196/14975 ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. e14975 ◽  
Author(s):  
Abrar Alturkistani ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
Shirin Aliabadi ◽  
Rosemary H Jenkins ◽  
...  

Background Patient portals are digital health tools adopted by health care organizations. The portals are generally connected to the electronic health record of the health care organization and offer patients functionalities such as access to the medical record, ability to order repeat prescriptions, make appointments, or message the health care provider. Patient portals may be beneficial for both patients and the health care system. Patient portals can widely differ from one context to another due to the differences in the portal functionalities and capabilities and it is anticipated that outcomes associated with the functionalities also differ. Current systematic reviews report outcomes associated with patient portal uptake but do not explicitly specify the patient portal functionalities. Objective The aim of this systematic review is to synthesize the evidence on health and health care quality outcomes associated with patient portal use among adult (18 years or older) patients. The review research questions are as follows: What kind of health outcomes do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? and What kind of health care quality outcomes, including health care utilization outcomes, do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? Methods The systematic review will be conducted by searching the MEDLINE, EMBASE, and Scopus databases for relevant literature. The review inclusion criteria will be studies about adult patients (18 years or older), studies only about tethered patient portals, and studies with or without a comparator. We will report patient portal–associated health and health care quality outcomes based on the patient portal functionalities. All quantitative primary study types will be included. Risk of bias of included studies will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and the National Heart, Lung, and Blood Institute’s quality assessment tools. Data will be synthesized using narrative synthesis and will be reported according to the patient portal functionalities, country, disease, and health care system model. Results Searches will be conducted in September 2019, and the review is anticipated to be completed by the end of June 2020. Conclusions This systematic review will provide an overview of health and health care quality outcomes associated with patient portal use among adult patients, providing detailed information about the functionalities of the portals and their associations with the outcomes. The review could potentially help patient portal evaluation studies by providing insights into outcomes associated with the different functionalities of patient portals. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141131 International Registered Report Identifier (IRRID) PRR1-10.2196/14975


2019 ◽  
Author(s):  
Abrar Alturkistani ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
Shirin Aliabadi ◽  
Rosemary H Jenkins ◽  
...  

BACKGROUND Patient portals are digital health tools adopted by health care organizations. The portals are generally connected to the electronic health record of the health care organization and offer patients functionalities such as access to the medical record, ability to order repeat prescriptions, make appointments, or message the health care provider. Patient portals may be beneficial for both patients and the health care system. Patient portals can widely differ from one context to another due to the differences in the portal functionalities and capabilities and it is anticipated that outcomes associated with the functionalities also differ. Current systematic reviews report outcomes associated with patient portal uptake but do not explicitly specify the patient portal functionalities. OBJECTIVE The aim of this systematic review is to synthesize the evidence on health and health care quality outcomes associated with patient portal use among adult (18 years or older) patients. The review research questions are as follows: What kind of health outcomes do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? and What kind of health care quality outcomes, including health care utilization outcomes, do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? METHODS The systematic review will be conducted by searching the MEDLINE, EMBASE, and Scopus databases for relevant literature. The review inclusion criteria will be studies about adult patients (18 years or older), studies only about tethered patient portals, and studies with or without a comparator. We will report patient portal–associated health and health care quality outcomes based on the patient portal functionalities. All quantitative primary study types will be included. Risk of bias of included studies will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and the National Heart, Lung, and Blood Institute’s quality assessment tools. Data will be synthesized using narrative synthesis and will be reported according to the patient portal functionalities, country, disease, and health care system model. RESULTS Searches will be conducted in September 2019, and the review is anticipated to be completed by the end of June 2020. CONCLUSIONS This systematic review will provide an overview of health and health care quality outcomes associated with patient portal use among adult patients, providing detailed information about the functionalities of the portals and their associations with the outcomes. The review could potentially help patient portal evaluation studies by providing insights into outcomes associated with the different functionalities of patient portals. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141131 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/14975


2018 ◽  
Vol 3 (2) ◽  
pp. 72-82
Author(s):  
Leawaty Leawaty ◽  
Adik Wibowo

Medication error remain extremely common, and the health care system can do much more to prevent it. Electronic prescribing is increasingly being viewed by health care stakeholders as an important step toward improved medication safety, better management of medication costs, increased practice efficiency, and improved health care quality. However, the adoption of e-prescribing has been difficult to attain owing to numerous barriers throughout the industry. Even with all the benefits of e-prescribing, many providers and pharmacists remained hesitant about completely adopting an e-prescribing system. The main purpose of this study was to explore and to assess the barriers of electronic prescribing implementation. The methodology for this study followed the basic principles of a systematic review with PRISMA methode retrieved from online database PubMed using a keyword “barriers” OR “obstacles” AND “electronic prescribing” OR “electronic prescription” AND “implementation”. Finally 6 documents were selected by full text inclucion and assessed for eligibility. The result of the study are  inefficiency, the low uptake of the physicians, the cost of implementing the electronic prescription, system errors and the privacy and legacy. The conclusion from the studies should that electronic prescribing implementation barriers those we divided into 2 groups : the user factors and the system factors of the electronic prescription. Vendors or the consultants to facilitate more adequately the adoption of e-prescribing by giving the physicians the free trial and provide evaluation and improvement according to the physicians' needs for the features in the e-prescription.


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