Evaluation of user adoption during three module deployments of region-wide electronic patient record systems

Janols, Rebecka; Lind, Thomas; Göransson, Bengt; Sandblad, Bengt

doi:10.1016/j.ijmedinf.2014.02.003

Cited by 26 publications

(16 citation statements)

References 21 publications

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“…In contrast, general practitioners who reported that the number of patients treated had increased or had fallen had less predictive power. This would, therefore, confirm the available evidence, which associates the implementation of digital technologies in the health care field with specific organizational circumstances, in particular with workflow pressures that are not too heavy [ 39 , 46 , 47 ].…”

Section: Discussionsupporting

confidence: 76%

“…The variables with less explanatory power were related to general practitioners’ perceptions of whether or not eHealth usage increases patient access to health care or reduces pharmaceutical expenditure. Again, the variables with less explanatory power were related to the belief that electronic systems would disrupt health care provision[ 30 , 39 ]. It is important to ensure that the potential benefits of new technologies are clear to see within the organization through mechanisms of continuing evaluation and feedback [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Modeling and Predicting Outcomes of eHealth Usage by European Physicians: Multidimensional Approach from a Survey of 9196 General Practitioners

et al. 2018

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BackgroundThe literature has noted the need to use more advanced methods and models to evaluate physicians’ outcomes in the shared health care model that electronic health (eHealth) proposes.ObjectiveThe goal of our study was to design and evaluate a predictive multidimensional model of the outcomes of eHealth usage by European physicians.MethodsWe used 2012-2013 survey data from a sample of 9196 European physicians (general practitioners). We proposed and tested two composite indicators of eHealth usage outcomes (internal practices and practices with patients) through 2-stage structural equation modeling. Logistic regression (odds ratios, ORs) to model the predictors of eHealth usage outcomes indicators were also calculated.ResultsEuropean general practitioners who were female (internal practices OR 1.15, 95% CI 1.10-1.20; practices with patients OR 1.19, 95% CI 1.14-1.24) and younger—aged <35 years (internal practices OR 1.14, 95% CI 1.02-1.26; practices with patients OR 1.32, 95% CI 1.13-1.54) and aged 36-45 years (internal practices OR 1.16, 95% CI 1.06-1.28; practices with patients OR 1.21, 95% CI 1.10-1.33)—had a greater propensity toward favorable eHealth usage outcomes in internal practices and practices with patients. European general practitioners who positively valued information and communication technology (ICT) impact on their personal working processes (internal practices OR 5.30, 95% CI 4.73-5.93; practices with patients OR 4.83, 95% CI 4.32-5.40), teamwork processes (internal practices OR 4.19, 95% CI 3.78-4.65; practices with patients OR 3.38, 95% CI 3.05-3.74), and the doctor-patient relationship (internal practices OR 3.97, 95% CI 3.60-4.37; practices with patients OR 6.02, 95% CI 5.43-6.67) had a high propensity toward favorable effects of eHealth usage on internal practices and practices with patients. More favorable eHealth outcomes were also observed for self-employed European general practitioners (internal practices OR 1.33, 95% CI 1.22-1.45; practices with patients OR 1.10, 95% CI 1.03-1.28). Finally, general practitioners who reported that the number of patients treated in the last 2 years had remained constant (internal practices OR 1.08, 95% CI 1.01-1.17) or increased (practices with patients OR 1.12, 95% CI 1.03-1.22) had a higher propensity toward favorable eHealth usage outcomes.ConclusionsWe provide new evidence of predictors (sociodemographic issues, attitudes toward ICT impacts, and working conditions) that explain favorable eHealth usage outcomes. The results highlight the need to develop more specific policies for eHealth usage to address different realities.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Modeling and Predicting Outcomes of eHealth Usage by European Physicians: Multidimensional Approach from a Survey of 9196 General Practitioners

et al. 2018

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“…Workload increased the amount of work and tasks (or time required to perform them) needed to complete a clinical process, when compared with the workflow established before the eHealth intervention [ 19 , 22 , 36 , 69 , 73 , 85 , 87 , 93 , 95 , 98 , 99 , 107 ].…”

Section: Resultsmentioning

confidence: 99%

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature

Granja¹,

Janssen²,

Johansen³

2018

J Med Internet Res

460

383

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BackgroundeHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality.ObjectiveOur objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure.MethodsWe searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles.ResultsAmong the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical processes (n=2), and staff turnover (n=1).ConclusionsThe reviewed literature suggested that, to increase the likelihood of success of eHealth interventions, future research must ensure a positive impact in the quality of care, with particular attention given to improved diagnosis, clinical management, and patient-centered care. There is a critical need to perform in-depth studies of the workflow(s) that the intervention will support and to perceive the clinical processes involved.

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“…The efficient and effective use of a NIS depends to a great extent on the appropriate designs of these systems and how well they take the expectations and needs of nurses into consideration [910]. A poorly designed NIS can complicate the daily routines of nurses, possibly leading to problems related to the acceptance and use of these systems [1112].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Nursing Information Systems: Application of Usability Aspects in the Development of Systems

et al. 2017

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ObjectivesAs the largest group providing healthcare services, nurses require well-designed information systems in their practice. This study aims to evaluate the usability of nursing information systems (NIS).MethodsThis cross-sectional survey was conducted in 2015. The settings of the study consisted of four hospitals affiliated with three medical universities in Tehran (Iran). The subjects of the study included nurses who had access to and used a NIS developed by four major software companies. The data were collected using a modified version of a usability questionnaire known as IsoMetrics, based on the International Standard ISO 9241, Part 11. The questionnaire is composed of 35 questions divided into seven general criteria. The validity of the questionnaire was determined by experts in the field, and the reliability was checked using Cronbach's alpha (α = 0.91). The questionnaire was then distributed to 184 nurses.ResultsThe response rate was 64.6%. Among the seven ISO usability criteria, suitability for the task (3.10 ± 1.24) and suitability for learning (3.10 ± 1.27) had the highest mean value. The lowest mean value (2.37 ± 1.29) was related to the suitability for individualization.ConclusionsAddressing issues related to individualization and self-descriptiveness could improve the usability of nursing systems. Considering usability requirements in the design of a NIS will lead to the efficient and effective use of these systems.

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Evaluation of user adoption during three module deployments of region-wide electronic patient record systems

Cited by 26 publications

References 21 publications

Modeling and Predicting Outcomes of eHealth Usage by European Physicians: Multidimensional Approach from a Survey of 9196 General Practitioners

Modeling and Predicting Outcomes of eHealth Usage by European Physicians: Multidimensional Approach from a Survey of 9196 General Practitioners

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature

Evaluation of Nursing Information Systems: Application of Usability Aspects in the Development of Systems

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