The perceptions of medical specialists on the influence of Electronic Medical Record use on the quality of hospital care.

Abstract Background: Numerous publications show that Electronic Medical Record (EMR) systems may provide an important contribution to increasing the quality and effectiveness of care. There are indications that particularly the medical specialist plays an important role in the implementation of EMR systems in hospitals. Our goal in this study is to answer the question: which positive or negative factors influence, in the perception of medical specialists, the relation between the EMR use and the quality of medical care?Methods: To answer this question, a qualitative study was conducted in the period August until October 2018. Semi-structured interviews of around 90 minutes were held with twelve medical specialists of twelve different Dutch hospitals. For the analysis of the answers, we used the classification of factors that can influence the implementation of EMR systems based on a previously published taxonomy.Results: The participating interviewees were experienced medical specialists. Their experience within the hospitals concerned varies between 5 and 27 years. There is a spread across different types of hospitals and specialisms. When the answers received are categorised using a previously published taxonomy, the medical specialist considered technical factors the most significant barriers for EMR use to have a positive effect on quality of care, followed by the suboptimal change processes surrounding implementation. The categories ‘social’ and ‘psychological’ and ‘time’ come in at a shared third place. On the positive side, they also identified potential technical facilitators, particularly in the assured availability of information to all health professionals involved in the care of a patient. They see promise in using EMRs for medical decision support to improve quality of care, but consider these capabilities currently lacking.Conclusions: In comparison with the paper record, the interviewed medical specialists consider the digitalised record a great leap forward. Every involved health professional can access the patient data if desired at any time they need it. However, in practice, real quality improvement lags behind as long as, for instance, no one uses decision support no one uses decision support, good integrated analytic tools are missing, and the organisation of care is not adapted to these new possibilities.

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Medical Specialists' Perspectives on the Influence of Electronic Medical Record Use on the Quality of Hospital Care: Semistructured Interview Study (Preprint)

10.2196/preprints.27671 ◽

2021 ◽

Author(s):

Rube van Poelgeest ◽

Augustinus Schrijvers ◽

Albert Boonstra ◽

Kit Roes

Keyword(s):

Health Care ◽

Quality Of Care ◽

Decision Support ◽

Health Care Professionals ◽

Medical Decision ◽

Semistructured Interview ◽

Care Providers ◽

Major Barrier ◽

Medical Specialists

BACKGROUND Numerous publications show that electronic medical records (EMRs) may make an important contribution to increasing the quality of care. There are indications that particularly the medical specialist plays an important role in the use of EMRs in hospitals. OBJECTIVE The aim of this study was to examine how, and by which aspects, the relationship between EMR use and the quality of care in hospitals is influenced according to medical specialists. METHODS To answer this question, a qualitative study was conducted in the period of August-October 2018. Semistructured interviews of around 90 min were conducted with 11 medical specialists from 11 different Dutch hospitals. For analysis of the answers, we used a previously published taxonomy of factors that can influence the use of EMRs. RESULTS The professional experience of the participating medical specialists varied between 5 and 27 years. Using the previously published taxonomy, these medical specialists considered technical barriers the most significant for EMR use. The suboptimal change processes surrounding implementation were also perceived as a major barrier. A final major problem is related to the categories “social” (their relationships with the patients and fellow care providers), “psychological” (based on their personal issues, knowledge, and perceptions), and “time” (the time required to select, implement, and learn how to use EMR systems and subsequently enter data into the system). However, the medical specialists also identified potential technical facilitators, particularly in the assured availability of information to all health care professionals involved in the care of a patient. They see promise in using EMRs for medical decision support to improve the quality of care but consider these possibilities currently lacking. CONCLUSIONS The 11 medical specialists shared positive experiences with EMR use when comparing it to formerly used paper records. The fact that involved health care professionals can access patient data at any time they need is considered important. However, in practice, potential quality improvement lags as long as decision support cannot be applied because of the lack of a fully coded patient record.

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Medical Specialists' Perspectives on the Influence of Electronic Medical Record Use on the Quality of Hospital Care: Semistructured Interview Study

JMIR Human Factors ◽

10.2196/27671 ◽

2021 ◽

Vol 8 (4) ◽

pp. e27671

Author(s):

Rube van Poelgeest ◽

Augustinus Schrijvers ◽

Albert Boonstra ◽

Kit Roes

Keyword(s):

Health Care ◽

Quality Of Care ◽

Decision Support ◽

Health Care Professionals ◽

Medical Decision ◽

Semistructured Interview ◽

Care Providers ◽

Major Barrier ◽

Medical Specialists

Background Numerous publications show that electronic medical records (EMRs) may make an important contribution to increasing the quality of care. There are indications that particularly the medical specialist plays an important role in the use of EMRs in hospitals. Objective The aim of this study was to examine how, and by which aspects, the relationship between EMR use and the quality of care in hospitals is influenced according to medical specialists. Methods To answer this question, a qualitative study was conducted in the period of August-October 2018. Semistructured interviews of around 90 min were conducted with 11 medical specialists from 11 different Dutch hospitals. For analysis of the answers, we used a previously published taxonomy of factors that can influence the use of EMRs. Results The professional experience of the participating medical specialists varied between 5 and 27 years. Using the previously published taxonomy, these medical specialists considered technical barriers the most significant for EMR use. The suboptimal change processes surrounding implementation were also perceived as a major barrier. A final major problem is related to the categories “social” (their relationships with the patients and fellow care providers), “psychological” (based on their personal issues, knowledge, and perceptions), and “time” (the time required to select, implement, and learn how to use EMR systems and subsequently enter data into the system). However, the medical specialists also identified potential technical facilitators, particularly in the assured availability of information to all health care professionals involved in the care of a patient. They see promise in using EMRs for medical decision support to improve the quality of care but consider these possibilities currently lacking. Conclusions The 11 medical specialists shared positive experiences with EMR use when comparing it to formerly used paper records. The fact that involved health care professionals can access patient data at any time they need is considered important. However, in practice, potential quality improvement lags as long as decision support cannot be applied because of the lack of a fully coded patient record.

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Integrating Patient-Generated Health Data in an Electronic Medical Record: Stakeholders’ Perspectives

Studies in Health Technology and Informatics - Integrated Citizen Centered Digital Health and Social Care ◽

10.3233/shti200685 ◽

2020 ◽

Author(s):

Katherine Blondon ◽

Frederic Ehrler

Keyword(s):

Patient Safety ◽

Quality Of Care ◽

Focus Group ◽

Medical Record ◽

Electronic Medical Record ◽

Health Data ◽

Improve Quality

Patient-generated health data (PGHD), when shared with the provider, provides potential as an approach to improve quality of care. Based on interviews and a focus group with stakeholders involved in PGHD integration in the electronic medical record (EMR), we explore the benefits, barriers and possible risks. We propose solutions to address liability concerns, such as clarifying patient and provider expectations for the analyses of PGHD and emphasize considerations for future steps, which include the need to screen PGHD for patient safety.

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Minimizing Medical Radiation Exposure by Incorporating a New Radiation “Vital Sign” into the Electronic Medical Record: Quality of Care and Patient Safety

The Permanente Journal ◽

10.7812/tpp/17-007 ◽

2017 ◽

Cited By ~ 1

Author(s):

Jonathan Lukoff

Keyword(s):

Patient Safety ◽

Quality Of Care ◽

Radiation Exposure ◽

Medical Record ◽

Electronic Medical Record ◽

Vital Sign ◽

Medical Radiation ◽

Medical Radiation Exposure

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Identifying individuals with multiple sclerosis in an electronic medical record

Multiple Sclerosis Journal ◽

10.1177/1352458514538334 ◽

2014 ◽

Vol 21 (2) ◽

pp. 217-224 ◽

Cited By ~ 20

Author(s):

Kristen M Krysko ◽

Noah M Ivers ◽

Jacqueline Young ◽

Paul O’Connor ◽

Karen Tu

Keyword(s):

Primary Care ◽

Quality Of Care ◽

Medical Record ◽

Electronic Medical Record ◽

Primary Care Physicians ◽

Policy Makers ◽

Patient Profile ◽

Physician Billing ◽

Chart Abstraction

Background: The increasing use of electronic medical records (EMRs) presents an opportunity to efficiently evaluate and improve quality of care for individuals with MS. Objectives: We aimed to establish an algorithm to identify individuals with MS within EMRs. Methods: We used a sample of 73,003 adult patients from 83 primary care physicians in Ontario using the Electronic Medical Record Administrative data Linked Database (EMRALD). A reference standard of 247 individuals with MS was identified through chart abstraction. The accuracy of identifying individuals with MS in an EMR was assessed using information in the cumulative patient profile (CPP), prescriptions and physician billing codes. Results: An algorithm identifying MS in the CPP performed well with 91.5% sensitivity, 100% specificity, 98.7% PPV and 100% NPV. The addition of prescriptions for MS-specific medications and physician billing code 340 used four times within any 12-month timeframe slightly improved the sensitivity to 92.3% with a PPV of 97.9%. Conclusions: Data within an EMR can be used to accurately identify patients with MS. This study has positive implications for clinicians, researchers and policy makers as it provides the potential to identify cohorts of MS patients in the primary care setting to examine quality of care.

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A study on perception of clinicians regarding use of electronic medical record for patients attending outpatient departments in a tertiary care teaching hospital in northern India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20205700 ◽

2020 ◽

Vol 8 (1) ◽

pp. 237

Author(s):

Samarpita Dutta ◽

Nirupam Madaam ◽

Parmeshwar Kumar

Keyword(s):

Quality Of Care ◽

Medical Record ◽

Electronic Medical Record ◽

Tertiary Care ◽

Background Information ◽

Care Hospital ◽

Outpatient Departments ◽

Computer Based ◽

The Mean

Background: Information technology is increasingly being recognized as an important tool for improving patient safety and quality of care. Use of electronic medical record has the greatest potential for improving quality in healthcare. Use of technology in a highly interactive environment such as the OPD has to be user friendly and acceptable. Therefore a study was carried out to assess the perception of clinicians regarding use of computer modules in clinical care in the outpatient departments of a tertiary care hospital in northern India.Methods: A cross sectional study was carried out over a period of two months in which 70 clinicians in the selected hospital were administered pre-designed questionnaire format for self reporting. It required them to rate their preferences regarding adoption of a computer based module for their OPDs and how this would affect their time and quality of patient care.Results: For a given computer based module in OPD, 81.4% of the clinicians supported its adoption. The mean scores suggested that most clinicians perceive that use of electronic medical record would improve quality of care. The mean scores for any of the parameters did not differ significantly amongst supporters and non-supporters of adoption of the module except on one parameter that it would be easier to follow a patient seen earlier by another clinician (p<0.05).Conclusions: Although there might be an initial resistance to change, overall clinicians perceive that introduction of electronic medical records on outpatient department would lead to improved quality of medical information management.

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