Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

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Why Do Physicians Reject the Electronic Health Record: A Theoretical Perspective? (Preprint)

10.2196/preprints.13066 ◽

2018 ◽

Author(s):

Weam Alfayez ◽

Arwa Alumran ◽

Dr Saja A. Al-Rayes

Keyword(s):

Information Technology ◽

Electronic Health Record ◽

Technology Acceptance ◽

Technology Acceptance Model ◽

Health Record ◽

Record System ◽

Factors Influencing ◽

Tam Model ◽

Electronic Health ◽

Acceptance Model

BACKGROUND Many theories/ models adopted from behavioral sciences literature or developed within the field of information technologies could help in understanding the technology acceptance, usage, and effective adoption. OBJECTIVE The main aim of this paper is to review the different theories/ models that can help in understanding information technology/system acceptance and use, and to choose the most appropriate theoretical framework that could be applied to understand the factors influencing physicians’ use of the Electronic Health Record system (EHR) at King Fahd Military Medical Complex (KFMMC) in Dhahran city, Saudi Arabia. METHODS The theories/ models were reviewed using scientific databases. The inclusion criteria were if the theories/ models used to explain individual behaviors toward accepting and using of information technology including the once conducted within the healthcare. RESULTS The review showed that there were five theories/ models were used within information technology studies to understand the technology acceptance and used. There were Theory of Reasoned Action, Theory of Planned Behaviour, Innovation Diffusion Theory, Unified theory of acceptance and use of technology, and Technology Acceptance Model. Each has different explanatory power of technology use. The most appropriate theoretical framework to understand the reason behind physician use of the EHR at KFMMC would be the Technology Acceptance Model (TAM). TAM model could explain up to 75% of the variation in the behavioral intention (acceptance), and up to 62% of the variation in the actual use. It is the gold standard for assessing the usage of health technologies and systems. In fact, the TAM model is one of the core models used to explore the physician’s perceptions of the Electronic Health Record system adoption. CONCLUSIONS This review showed that there are different theories available in the literature can be used to justify the reason behind electronic health record acceptance. TAM is one of the effective, simplest models used to understand the factors influencing physicians to use the EHR-system. Further studies need to apply the TAM model to check its ability in explaining the reason behind EHR within different hospitals in Saudi Arabia

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Electronic Health Records Implementation in Jordan: Perceptions of Healthcare Providers and Determinant Factors (Preprint)

10.2196/preprints.23732 ◽

2020 ◽

Author(s):

Tamadur Shudayfat ◽

Çağdaş Akyürek ◽

Noha Al-Shdayfat ◽

Hatem Alsaqqa

Keyword(s):

Electronic Health Records ◽

Electronic Health Record ◽

Technology Acceptance ◽

Technology Acceptance Model ◽

Healthcare Providers ◽

Health Record ◽

Health Records ◽

Context Factors ◽

Electronic Health ◽

Acceptance Model

BACKGROUND Acceptance of Electronic Health Record systems is considered an essential factor for an effective implementation among the Healthcare providers. In an attempt to understand the healthcare providers’ perceptions on the Electronic Health Record systems implementation and evaluate the factors influencing healthcare providers’ acceptance of Electronic Health Records, the current research examines the effects of individual (user) context factors, and organizational context factors, using Technology Acceptance Model. OBJECTIVE The current research examines the effects of individual (user) context factors, and organizational context factors, using Technology Acceptance Model. METHODS A quantitative cross-sectional survey design was used, in which 319 healthcare providers from five public hospital participated in the present study. Data was collected using a self-administered questionnaire, which was based on the Technology Acceptance Model. RESULTS Jordanian healthcare providers demonstrated positive perceptions of the usefulness and ease of use of Electronic Health Record systems, and subsequently, they accepted the technology. The results indicated that they had a significant effect on the perceived usefulness and perceived ease of use of Electronic Health Record, which in turn was related to positive attitudes towards Electronic Health Record systems as well as the intention to use them. CONCLUSIONS User attributes, organizational competency, management support and training and education are essential variables in predicting healthcare provider’s acceptance toward Electronic Health records. These findings should be considered by healthcare organizations administration to introduce effective system to other healthcare organizations.

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Electronic Health Record Acceptance by Physicians: A Single Hospital Experience in Daily Practice

BioMedInformatics ◽

10.3390/biomedinformatics1010002 ◽

2021 ◽

Vol 1 (1) ◽

pp. 6-17

Author(s):

Andrija Pavlovic ◽

Nina Rajovic ◽

Jasmina Pavlovic Stojanovic ◽

Debora Akinyombo ◽

Milica Ugljesic ◽

...

Keyword(s):

Health Care ◽

Logistic Regression ◽

Electronic Health Record ◽

Technology Acceptance ◽

Daily Practice ◽

Ease Of Use ◽

Future Research ◽

Health Record ◽

Cross Sectional ◽

Electronic Health

Introduction: Potential benefits of implementing an electronic health record (EHR) to increase the efficiency of health services and improve the quality of health care are often obstructed by the unwillingness of the users themselves to accept and use the available systems. Aim: The aim of this study was to identify factors that influence the acceptance of the use of an EHR by physicians in the daily practice of hospital health care. Material and Methods: The cross-sectional study was conducted among physicians in the General Hospital Pancevo, Serbia. An anonymous questionnaire, developed according to the technology acceptance model (TAM), was used for the assessment of EHR acceptance. The response rate was 91%. Internal consistency was assessed by Cronbach’s alpha coefficient. A logistic regression analysis was used to identify the factors influencing the acceptance of the use of EHR. Results: The study population included 156 physicians. The mean age was 46.4 ± 10.4 years, 58.8% participants were female. Half of the respondents (50.1%) supported the use of EHR in comparison to paper patient records. In multivariate logistic regression modeling of social and technical factors, ease of use, usefulness, and attitudes towards use of EHR as determinants of the EHR acceptance, the following predictors were identified: use of a computer outside of the office for reading daily newspapers (p = 0.005), EHR providing a greater amount of valuable information (p = 0.007), improvement in the productivity by EHR use (p < 0.001), and a statement that using EHR is a good idea (p = 0.014). Overall the percentage of correct classifications in the model was 83.9%. Conclusion: In this research, determinants of the EHR acceptance were assessed in accordance with the TAM, providing an overall good model fit. Future research should attempt to add other constructs to the TAM in order to fully identify all determinants of physician acceptance of EHR in the complex environment of different health systems.

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Transitioning from one Electronic Health Record (EHR) to Another: A Narrative Literature Review

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1541931218621112 ◽

2018 ◽

Vol 62 (1) ◽

pp. 489-493 ◽

Cited By ~ 2

Author(s):

Jason J. Saleem ◽

Jennifer Herout

Keyword(s):

Health Care ◽

Literature Review ◽

Electronic Health Record ◽

Health Care Systems ◽

Health Care Organization ◽

Data Migration ◽

Health Record ◽

Care Organization ◽

Healthcare Organizations ◽

Electronic Health

This paper reports the results of a literature review of health care organizations that have transitioned from one electronic health record (EHR) to another. Ten different EHR to EHR transitions are documented in the academic literature. In eight of the 10 transitions, the health care organization transitioned to Epic, a commercial EHR which is dominating the market for large and medium hospitals and health care systems. The focus of the articles reviewed falls into two main categories: (1) data migration from the old to new EHR and (2) implementation of the new EHR as it relates to patient safety, provider satisfaction, and other measures pre-and post-transition. Several conclusions and recommendations are derived from this review of the literature, which may be informative for healthcare organizations preparing to replace an existing EHR. These recommendations are likely broadly relevant to EHR to EHR transitions, regardless of the new EHR vendor.

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Implementation and evaluation of Stanford Health Care store-and-forward teledermatology consultation workflow built within an existing electronic health record system

Journal of Telemedicine and Telecare ◽

10.1177/1357633x18799805 ◽

2018 ◽

Vol 26 (3) ◽

pp. 125-131 ◽

Cited By ~ 5

Author(s):

Grace E Kim ◽

Olga K Afanasiev ◽

Chris O’Dell ◽

Christopher Sharp ◽

Justin M Ko

Keyword(s):

Health Care ◽

Electronic Health Record ◽

Primary Care Physicians ◽

Health Record ◽

Record System ◽

Privacy Concerns ◽

Successful Model ◽

Dermatology Clinic ◽

Electronic Health ◽

Store And Forward

Introduction Teledermatology services that function separately from patients’ primary electronic health record (EHR) can lead to fragmented care, poor provider communication, privacy concerns and billing challenges. This study addresses these challenges by developing PhotoCareMD, a store-and-forward (SAF) teledermatology consultation workflow built entirely within an existing Epic-based EHR. Methods Thirty-six primary care physicians (PCPs) from eight outpatient clinics submitted 215 electronic consults (eConsults) for 211 patients to a Stanford Health Care dermatologist via PhotoCareMD. Comparisons were made with in-person referrals for this same dermatologist prior to initiation of PhotoCareMD. Results Compared to traditional in-person dermatology clinic visits, eConsults decreased the time to diagnosis and treatment from 23 days to 16 hours. The majority (73%) of eConsults were resolved electronically. In-person referrals from PhotoCareMD (27%) had a 50% lower cancellation rate compared with traditional referrals (11% versus 22%). The average in-person visit and documentation was 25 minutes compared with 8 minutes for an eConsult. PhotoCareMD saved 13 additional clinic hours to be made available to the dermatologist over the course of the pilot. At four patients per hour, this opens 52 dermatology clinic slots. Over 96% of patients had a favourable experience and 95% felt this service saved them time. Among PCPs, 100% would recommend PhotoCareMD to their colleagues and 95% said PhotoCareMD was a helpful educational tool. Discussion An internal SAF teledermatology workflow can be effectively implemented to increase access to and quality of dermatologic care. Our workflow can serve as a successful model for other hospitals and specialties.

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Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System

JMIR Research Protocols ◽

10.2196/25148 ◽

2021 ◽

Vol 10 (3) ◽

pp. e25148

Author(s):

Ahmed Umar Otokiti ◽

Catherine K Craven ◽

Avniel Shetreat-Klein ◽

Stacey Cohen ◽

Bruce Darrow

Keyword(s):

Health Care ◽

Data Analysis ◽

Electronic Health Record ◽

Health Record ◽

User Centered Design ◽

Pilot Phase ◽

Direct Input ◽

Electronic Health ◽

The Impact ◽

User Centered

Background Up to 60% of health care providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on health care quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. Objective This project aims to improve the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies via user-centered design has the potential to improve usability, thereby increasing satisfaction by reducing EHR-induced burnout. Methods Quantitative and qualitative data will be obtained from clinician EHR users. The input will be received through a form built in a REDCap database via a link embedded in the home page of the EHR. The REDCap data will be analyzed in 2 main dimensions, based on nature of the input, what section of the EHR is affected, and what is required to fix the issue(s). Identified issues will be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a Plan-Do-Study-Act (PDSA) manner every 4-6 weeks. Results The pilot phase of the study began in October 2020 in the Gastroenterology Division at Mount Sinai Hospital, New York City, NY, which includes 39 physicians and 15 nurses. The pilot is expected to run over a 4-6–month period. The results of the REDCap data analysis will be reported within 1 month of completing the pilot phase. We will analyze the nature of requests received and the impact of rectified issues on the clinician EHR user. We expect that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by evaluation survey and other qualitative methods where possible. Conclusions The project aims to improve user-centered design of the EHR by soliciting direct input from clinician EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics expertise to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement. International Registered Report Identifier (IRRID) PRR1-10.2196/25148

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Validation of a Novel Electronic Health Record Patient Portal Advance Care Planning Delivery System

Journal of Medical Internet Research ◽

10.2196/jmir.9203 ◽

2018 ◽

Vol 20 (6) ◽

pp. e208 ◽

Cited By ~ 12

Author(s):

Seuli Bose-Brill ◽

Michelle Feeney ◽

Laura Prater ◽

Laura Miles ◽

Angela Corbett ◽

...

Keyword(s):

Electronic Health Record ◽

Delivery System ◽

Advance Care Planning ◽

Health Record ◽

Patient Portal ◽

Care Planning ◽

Advance Care ◽

Electronic Health

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Mobile Health Systems and Electronic Health Record

Consumer-Driven Technologies in Healthcare ◽

10.4018/978-1-5225-6198-9.ch002 ◽

2019 ◽

pp. 15-33

Author(s):

Kijpokin Kasemsap

Keyword(s):

Health Care ◽

Global Health ◽

Electronic Health Record ◽

Health Systems ◽

Mobile Health ◽

Health Record ◽

Care Services ◽

Global Health Care ◽

Mobile Health Systems ◽

Electronic Health

This chapter reveals the overview of mobile health systems; the adoption of mobile health systems; mobile health systems and patient monitoring; the overview of mobile health technology; the advanced issues of Electronic Health Record (EHR); and the challenges of EHR in global health care. Mobile health helps deliver the health care services with quality care, improved workflow, and increased patient interaction while minimizing complexity and cost to achieve the desired goals in health care settings. EHR systems are the real-time and patient-centered records that make information available instantly and securely to authorized users. The chapter argues that applying mobile health systems and EHR has the potential to improve health care efficiency and gain sustainable competitive advantage in global health care.

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Addressing Burnout Syndrome From a Critical Care Specialty Organization Perspective

AACN Advanced Critical Care ◽

10.4037/aacnacc2020579 ◽

2020 ◽

Vol 31 (2) ◽

pp. 158-166

Author(s):

Kathryn L. Cochran ◽

Kathleen Doo ◽

Allison Squires ◽

Tina Shah ◽

Seppo Rinne ◽

...

Keyword(s):

Health Care ◽

Electronic Health Record ◽

High Stress ◽

Well Being ◽

American Thoracic Society ◽

Burnout Syndrome ◽

Health Record ◽

Cross Sectional ◽

Electronic Health ◽

At Home

Background: Health care specialty organizations are an important resource for their membership; however, it is not clear how specialty societies should approach combating stress and burnout on an organizational scale. Objective: To understand the prevalence of burnout syndrome in American Thoracic Society members, identify specialty-specific risk factors, and generate strategies for health care societies to combat burnout. Methods: Cross-sectional, mixed-methods survey in a sample of 2018 American Thoracic Society International Conference attendees to assess levels of burnout syndrome, work satisfaction, and stress. Results: Of the 130 respondents, 69% reported high stress, 38% met burnout criteria, and 20% confirmed chaotic work environments. Significant associations included sex and stress level; clinical time and at-home electronic health record work; and US practice and at-home electronic health record work. There were no significant associations between burnout syndrome and the selected demographics. Participants indicated patient care as the most meaningful aspect of work, whereas the highest contributors to burnout were workload and electronic health record documentation. Importantly, most respondents were unaware of available resources for burnout. Conclusions: Health care specialty societies have access to each level of the health system, creating an opportunity to monitor trends, disseminate resources, and influence the direction of efforts to reduce workplace stress and enhance clinician well-being.

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