Implementation of an electronic health records system in a small clinic: the viewpoint of clinic staff

Abstract

In this study, we examined the implementation of an electronic health records (EHR) system in a small family practice clinic. We used three data collection instruments to evaluate user experience, work pattern changes, and organisational changes related to the implementation and use of the EHR system: (1) an EHR user survey, (2) interviews with key personnel involved in the EHR implementation project, and (3) a work analysis of clinic staff. A longitudinal design with two data-collection rounds was employed: data were collected prior to EHR implementation and after EHR implementation. Both quantitative and qualitative data were collected and analysed. Employees of the small clinic perceived few changes in their work after the implementation of the EHR system, except for increased dependency on computers and a small increase in perceived workload. The work analysis showed a dramatic increase in the amount of time spent on computers by the various job categories. The EHR implementation did not change the amount of time spent by physicians with patients. On the other hand, the work of clinical and office staff changed significantly, and included decreases in time spent distributing charts, transcription and other clerical tasks. The interviews provided important contextual information regarding EHR implementation, and showed some positive elements (e.g., planning of training), but also some negative elements (e.g., unclear structure of the project) that would have deserved additional attention.

Survey of Primary-Care Providers on Perceived Benefits of and Barriers to PainTracker

“…The Technology Acceptance Model (TAM) 21 was the conceptual framework used to develop the core outcomes of “ease of use,” “clinical usefulness,” and “barriers to use.” Five experts in the field of nursing, psychology, and medicine, who have experience in direct patient care and research in chronic pain, including the author of PainTracker, were consulted throughout the iterative process of item development. The item responses were constructed with a 5-point Likert scale including the options of strongly agree , agree , no opinion , disagree , and strongly disagree .…”

A systematic review of mixed methods research on human factors and ergonomics in health care

“…work sampling study, survey and interviews) to evaluate the implementation and impact of an Electronic Health Record (EHR) technology in a primary care clinic (Carayon, Smith, Hundt, Kuruchittham, & Li, 2009). The quantitative data produced by the work sampling method assessed changes in time spent on various activities by different groups of clinic workers (i.e.…”

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Layered Implementation View of a SOA Based Electronic Health Record

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