Implementing electronic medical records in a psychiatric hospital: A qualitative study

Patients’ access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients’ attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital.

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Barriers to high quality coding of hospital chart information to administrative data: A qualitative study

International Journal for Population Data Science ◽

10.23889/ijpds.v1i1.39 ◽

2017 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Karen Tang ◽

Kelsey Lucyk ◽

Hude Quan

Keyword(s):

Qualitative Study ◽

Electronic Medical Records ◽

Administrative Data ◽

Medical Records ◽

Health Service Delivery ◽

Structured Interview ◽

Recruitment Strategy ◽

Physician Education ◽

High Quality ◽

Patient Journey

ABSTRACTObjectives Administrative data are widely used in research, health policy, and the evaluation of health service delivery. We undertook a qualitative study to explore the barriers to high quality coding of chart information to administrative data, at the level of coders in Canada. ApproachOur study design is qualitative. We recruited professional medical chart coders and data users working across Alberta, Canada, using a multimodal recruitment strategy. We conducted an in-depth, semi-structured interview with each participant. All interviews were audio-recorded and transcribed. We conducted thematic analysis (e.g., line-by-line open coding) of interview transcripts. Codes were then collated into themes and compared across our dataset to ensure accurate interpretations of the data. The study team met to discuss, modify, and interpret emergent themes in the context of the barriers to coding administrative data. ResultsWe recruited 28 coding specialists. In general, coders had high job satisfaction and sense of collegiality, as well as sufficient resources to address their coding questions. They believed themselves to be adequately trained and consistently put in the extra effort when searching charts to find additional information that accurately reflected the patient journey. Barriers to high quality coding from the coder perspective included: 1) Incomplete and inaccurate information in physician progress notes and discharge summaries; 2) Difficulty navigating a complex hybrid of paper and electronic medical records; 3) Focus on productivity rather than quality by the employer, which at times resulted in inconsistent instructions for coding secondary diagnoses and discordant expectations between the employer and the coders’ professional standards. ConclusionFuture interventions to improve the quality of administrative data should focus on physician education of necessary components in charting, evaluation of electronic medical records from the perspectives of those who play a key role in abstracting data, and evaluation of productivity guidelines for coders and their effects on data quality.

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Validation of a Professionals’ Satisfaction Questionnaire with Electronic Medical Records (PSQ-EMR) in Psychiatry

European Psychiatry ◽

10.1016/j.eurpsy.2009.10.007 ◽

2010 ◽

Vol 26 (2) ◽

pp. 78-84 ◽

Cited By ~ 7

Author(s):

L. Boyer ◽

K. Baumstarck-Barrau ◽

R. Belzeaux ◽

J.M. Azorin ◽

J.M. Chabannes ◽

...

Keyword(s):

Health Care ◽

Electronic Medical Records ◽

Psychiatric Hospital ◽

Internal Consistency ◽

Health Care Professionals ◽

Medical Records ◽

External Validity ◽

Reduction Process ◽

Psychiatric Hospitals ◽

Satisfaction Questionnaire

AbstractBackgroundElectronic medical records (EMR) are currently being implemented in psychiatric hospitals throughout Europe. The perceptions of health care professionals can contribute important information that may predict their acceptance of and desired mode of use for EMR, thus guiding EMR implementation.AimsTo develop a self-administered instrument designed to assess health care professionals’ satisfaction regarding EMR in a psychiatric hospital, based only on the professional point of view, according to the psychometric standards.MethodsThe development was supervised by a steering committee and undertaken by three standard steps. Item generation was derived from 115 face-to-face interviews with health care professionals in a French, public, psychiatric hospital. The item-reduction process resulted in a 25-item questionnaire. The validation process was based on construct validity, reliability and some aspects of external validity.ResultsThe final version of the questionnaire contained 25 items that described five dimensions, leading to a global score. The factor structure accounted for 72% of the total variance. Internal consistency was satisfactory (item-internal consistency over 0.40 and Cronbach's alpha coefficients ranged from 0.86 to 0.95). The scalability was satisfactory with INFIT statistics inside an acceptable range. Scores of dimensions were strongly positively correlated with visual analogue scale scores (all p < 0.001). External validity showed statistical associations between scores and age, gender, seniority in psychiatry and ward type. Participation rate was 66%.ConclusionThe availability of a reliable and valid questionnaire (professionals’ satisfaction questionnaire with electronic medical records [PSQ-EMR]) concerning health care professionals’ satisfaction regarding EMR in psychiatry, exclusively generated from interviews with health care professionals, enables legitimate feedback to be incorporated into EMR implementation in order to formulate a high-quality health care.

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How do general practitioners access guidelines and utilise electronic medical records to make clinical decisions on antibiotic use? Results from an Australian qualitative study

BMJ Open ◽

10.1136/bmjopen-2018-028329 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028329 ◽

Cited By ~ 5

Author(s):

Ruby Biezen ◽

Cassandra Roberts ◽

Kirsty Buising ◽

Karin Thursky ◽

Douglas Boyle ◽

...

Keyword(s):

Decision Support ◽

Qualitative Study ◽

Electronic Medical Records ◽

General Practitioners ◽

Clinical Decision Support ◽

Medical Records ◽

Clinical Decision ◽

Antibiotic Prescribing ◽

Evidence Based ◽

Practice Culture

ObjectiveThis study aimed to explore how general practitioners (GPs) access and use both guidelines and electronic medical records (EMRs) to assist in clinical decision-making when prescribing antibiotics in Australia.DesignThis is an exploratory qualitative study with thematic analysis interpreted using the Theory of Planned Behaviour (TPB) framework.SettingThis study was conducted in general practice in Victoria, Australia.ParticipantsTwenty-six GPs from five general practices were recruited to participate in five focus groups between February and April 2018.ResultsGPs expressed that current EMR systems do not provide clinical decision support to assist with antibiotic prescribing. Access and use of guidelines were variable. GPs who had more clinical experience were less likely to access guidelines than younger and less experienced GPs. Guideline use and guideline-concordant prescribing was facilitated if there was a practice culture encouraging evidence-based practice. However, a lack of access to guidelines and perceived patients’ expectation and demand for antibiotics were barriers to guideline-concordant prescribing. Furthermore, guidelines that were easy to access and navigate, free, embedded within EMRs and fit into the clinical workflow were seen as likely to enhance guideline use.ConclusionsCurrent barriers to the use of antibiotic guidelines include GPs’ experience, patient factors, practice culture, and ease of access and cost of guidelines. To reduce inappropriate antibiotic prescribing and to promote more rational use of antibiotic in the community, guidelines should be made available, accessible and easy to use, with minimal cost to practicing GPs. Integration of evidence-based antibiotic guidelines within the EMR in the form of a clinical decision support tool could optimise guideline use and increase guideline-concordant prescribing.

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