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

Abstract

The objective of this study is to examine health care professionals' opinions of the critical events (opportunities and barriers) surrounding EMR implementation in a French teaching psychiatric hospital. This qualitative study was based on semi-structured interviews with 115 health care professionals: 16 psychiatrists, 84 nurses, six psychologists or social assistants and nine secretaries or administrative professionals. Interviews were thematically analysed. Most responders (96%) used EMR. Among these EMR users, 70% perceived EMR positively. Concerning the opportunities from implementing an EMR, the most represented theme was "the improved access to medical record information" (75%), followed by "the strategy to guarantee the adhesion of professionals and the use of EMR" (69%), and "the technological performances of EMR" (49%). Concerning the barriers to implementation, four themes emerged, as follows: "the workflow and efficiency decrease" (73%), "the triangulation of the patient-professional relationship" (47%), "the information sharing and confidentiality" (32%), and "the ambiguity of EMR" (26%), which answers both to the production of care and to an economic issue. In conclusion, EMR implementation involved several critical components, and the strategy of implementation is particularly important. Implementing an EMR should be considered a continuous process, and the principle and theory of continuous quality improvement appears pertinent for addressing this problem.

Electronic Health Record Use by Nurses in Mental Health Settings: A Literature Review

“…These findings are encouraging and suggest that implementing EHRs in mental health settings may be less different than doing so in other clinical environments than previously thought. On the contrary, several studies found that mental health nurses felt that there were a number of deficiencies in their experience using the EHR (Ammenwerth et al, 2001;Baillie et al, 2012;Boyer et al, 2010;Edwards et al, 2011;Saloman et al, 2010;Stahl, Granlund, GareAndersson, & Enskar, 2011). A summary of the findings of the literature review is detailed below.…”

“…Several studies reported that nurses experienced a number of immediate benefits of the EHR once implemented (Ammenwerth et al, 2001;Baillie, Chadwick, Mann, & Brooke-Read, 2012;Boyer, Samuelian, Fieschi, & Lancon, 2010;Edwards, Chiweda, Oyinka, McKay, & Wiles, 2011). These findings are encouraging and suggest that implementing EHRs in mental health settings may be less different than doing so in other clinical environments than previously thought.…”

“…As multiple clinicians (and students) can simultaneously access a patients' chart using separate computers, a more efficient review and entry of patient information can be completed. Both nurses and students saw how this improved the quality of care provided, and also allowed them to spend more time with their patients (Baillie et al, 2012;Boyer et al, 2010). Given the importance of the therapeutic relationship in the mental health setting, freeing the nurse from charting to be able to spend more time with patients was seen as highly valuable.…”

Layered Implementation View of a SOA Based Electronic Health Record

“…Complexity of developing DOI reference number: 10.18293/SEKE2016-064 these software systems is well-known in the literature for many reasons, including heterogeneity of data and issues with interoperability between legacy systems [1], and design and architecture problems [2]. In addition, health applications are sensitive to important non-functional requirements, such as performance, security and safety of data [3] [4]. Therefore, developing and managing health information systems is a hard task.…”

Mobile Web Application Development to Access to Psychiatric Electronic Health Records

“…In the application OpenSDE, authors have expanded the traditional row modeling methodology with additional columns to allow structured representation of medical narrative (Los, 2004). In the EHRs system context, Electronic Medical Records (EMRs) are currently being implemented in psychiatric hospitals throughout Europe (Boyer, et al, 2009a;Boyer, et al, 2009b;Boyer, et al, 2011). Taking a look at the international scenario, it can be determined that EHRs are not equally adopted in all countries.…”