A standardized process in the electronic health record to identify and recruit family and other unpaid caregivers of Veterans for a caregiver survey study (Preprint)

2021 ◽  
Author(s):  
Jessica E. Ma ◽  
Janet Grubber ◽  
Cynthia J. Coffman ◽  
Virginia Wang ◽  
S. Nicole Hastings ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Survey Study ◽  
Health Record ◽  
Logistic Regression Models ◽  
Home And Community Care ◽  
Electronic Health ◽  
Unpaid Caregiver ◽  
Family Based ◽  
Adult Day Health Care ◽  
Systematic Identification

BACKGROUND Most efforts to identify caregivers for research use passive approaches like self-nomination. We describe an approach where the EHR can help identify, recruit, and increase diverse representation of caregivers. OBJECTIVE Few health systems have implemented systematic processes to identify caregivers. We aimed to evaluate an electronic health record (EHR) algorithm for identifying Veterans with caregivers. METHODS We identified initial cohorts of Veterans likely to need supportive care from friends or family based with pre-defined EHR referrals for home and community care. Veterans were contacted assess whether the Veteran had an unpaid caregivers; unpaid caregivers were then contacted and offered enrollment in a caregiver survey. We compared Veteran characteristics from the EHR across these referral, screening, and recruitment groups using descriptive statistics and logistic regression models. RESULTS Of 12,212 Veterans identified through EHR referrals, 2,134 (17.4%) were selected for screening and 1,367 (11.2%) answered phone screening; 813 (60%) of those screened had a caregiver, and 435 (53%) caregivers participated in a survey. Married veterans had increased odds of having a caregiver (adjusted OR 2.63 [95%CI 1.65-4.24]) or had an adult day health care referral (adjusted OR 3.06 [95%CI 1.38 – 7.76]) or a respite care referral (adjusted OR 2.21 [95%CI 1.45-3.44].) Caregivers of Veterans with dementia had increased odds of participating in the survey (adjusted OR 1.78 [95%CI 1.20-2.65]). CONCLUSIONS The EHR algorithm process is systematic, resource intensive, and imperfect. Sixty percent of successfully screened Veterans had an unpaid caregiver. Implementing discrete caregiver fields in the EHR would support more efficient systematic identification of caregivers. CLINICALTRIAL ClincalTrials.gov Identifier: NCT03474380.

scholarly journals User Evaluation of the Swedish Patient Accessible Electronic Health Record: System Usability Scale (Preprint)

2020 ◽  
Author(s):  
Maria Hägglund ◽  
Isabella Scandurra
Keyword(s):  
Electronic Health Record ◽  
Ease Of Use ◽  
Survey Study ◽  
Health Record ◽  
Patient Portal ◽  
Data Set ◽  
System Usability Scale ◽  
System Usability ◽  
National Patient ◽  
Electronic Health

BACKGROUND Transparency is increasingly called for in health care, especially, when it comes to patients’ access to their electronic health records. In Sweden, the e-service Journalen is a national patient accessible electronic health record (PAEHR), accessible online via the national patient portal. User characteristics and perceived benefits of using a PAEHR influence behavioral intention for use and adoption, but poor usability that increases the effort expectancy can have a negative impact. It is, therefore, of interest to explore how users of the PAEHR Journalen perceive its usability and usefulness. OBJECTIVE The aim of this study was to explore how the users of the Swedish PAEHR experience the usability of the system and to identify differences in these experiences based on the level of transparency of the region. METHODS A survey study was conducted to elicit opinions and experiences of patients using Journalen. The data were collected from June to October 2016. The questionnaire included questions regarding the usability of the system from the System Usability Scale (SUS). The SUS analysis was the focus of this paper. Analysis was performed on different levels: nationally looking at the whole data set and breaking it down by focusing on 2 different regions to explore differences in experienced usability based on the level of transparency. RESULTS During the survey period, 423,141 users logged into Journalen, of which 2587 unique users completed the survey (response rate 0.61%). The total mean score for all respondents to the SUS items was 79.81 (SD 14.25), which corresponds to a system with good usability. To further explore whether the level of transparency in a region would affect the user’s experience of the usability of the system, we analyzed the 2 regions with the most respondents: Region Uppsala (the first to launch, with a high level of transparency), and Region Skåne (an early implementer, with a low level of transparency at the time of the survey). Of the participants who responded to at least 1 SUS statement, 520 stated that they had received care in Region Skåne, whereas 331 participants had received care in Region Uppsala. Uppsala’s mean SUS score was 80.71 (SD 13.41), compared with Skåne’s mean of 79.37 (SD 13.78). CONCLUSIONS The Swedish national PAEHR Journalen has a reasonably good usability (mean SUS score 79.81, SD 14.25); however, further research into more specific usability areas are needed to ensure usefulness and ease of use in the future. A somewhat higher SUS score for the region with high transparency compared with the region with low transparency could indicate a relationship between the perceived usability of a PAEHR and the level of transparency offered, but further research on the relationship between transparency and usability is required.

scholarly journals Electronic health record implementations and insufficient training endanger nurses’ wellbeing: cross-sectional survey study (Preprint)

2021 ◽  
Author(s):  
Tarja Heponiemi ◽  
Tuulikki Vehko ◽  
Gluschkoff Kia ◽  
Anu Kaihlanen ◽  
Kaija Saranto ◽  
...  
Keyword(s):  
Information Systems ◽  
Electronic Health Record ◽  
Time Pressure ◽  
Survey Study ◽  
Health Record ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Employment Sector ◽  
Cognitive Failures ◽  
Electronic Health

BACKGROUND High expectations have been set for the implementations of health information systems (HIS) in health care. However, nurses have been dissatisfied after HIS implementations. Especially poorly functioning electronic health records (EHRs) have been found to induce stress and cognitive work load. Moreover, need to learn new systems may require a lot of effort from nurses. Thus, EHR implementations may have an effect on the wellbeing of nurses. OBJECTIVE To examine the associations of EHR implementations and sufficiency of related training with perceived stress related to information systems (SRIS), time pressure and cognitive failures among registered nurses. Moreover, we examined whether employment sector would have an effect on these associations. METHODS Cross-sectional survey study among 3610 Finnish registered nurses in 2020. EHR Implementation was measured by assessing whether respondents’ work unit had implemented or will implement a new electronic health record (EHR) a) within past 6 months, b) within past 12 months, c) forthcoming within next 12 months and 4) no past or forthcoming implementations within 12 months. The associations were examined using analyses of covariance adjusted for age, gender and employment sector. RESULTS Highest levels of SRIS and time pressure were experienced among those who had experienced a EHR implementation within past 6 months. Lowest levels of SRIS, time pressure and cognitive failures were among those who did not have any past or forthcoming implementations within 12 months. Nurses who perceived that they had received sufficient implementation-related training experienced less SRIS, time pressure and cognitive failures. Recent implementations and insufficient training were especially strongly associated with high levels of SRIS in hospitals. CONCLUSIONS EHR implementations and insufficient training related to those implementations may endanger the wellbeing of nurses and even lead to errors. Thus, it would be utmost important that organizations would offer comprehensive training before, during and after implementations. Moreover, easy to use systems, allowing transition periods, re-engineering approach and user involvement might help nurses in the implementation process. Training and other improvements would be especially important at hospitals.

Business: The Electronic Health Record: Front Line Experience

2011 ◽  
Vol 21 (1) ◽  
pp. 18-22
Author(s):  
Rosemary Griffin
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Electronic Health Record ◽  
Financial Incentives ◽  
Best Practice ◽  
Health Care Systems ◽  
The United States ◽  
Health Record ◽  
Health Trends ◽  
Electronic Health

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.

Sign in / Sign up

Export Citation Format

Share Document