Perceptions of allied health staff of the implementation of an integrated electronic medical record across regional and metropolitan settings

Abstract

ObjectiveThe aim of this study was to investigate the perceptions of allied health professionals (AHPs) to implementation of an integrated electronic medical record (EMR) across both regional and metropolitan settings. MethodsThe study was conducted as a cross-sectional electronic survey. AHPs working at three hospital sites within Queensland Health were sent an electronic survey link. Participation was voluntary and recruitment via a snowball sampling technique was encouraged. Responses were analysed descriptively. ResultsIn all, 104 responders completed the survey. Responders were distributed across three sites within the selected health service, with most (75%; n=78) being at the largest site. Physiotherapy accounted for the largest number of responders (22%). Most responders were female (87%; n=90) and between 20 and 40 years of age (68%; n=71). On a scale from 0 (being anxious) to 100 (being excited), at the time EMR implementation was announced, there was a trend towards excitement (mean score 59). The most commonly reported factor hindering EMR implementation was the opportunity to practice with EMR (34%), whereas clinical ‘change champions’ were reported as the most common facilitators (61%). Overall, 60% of responders were very satisfied or satisfied with the EMR, but limited effects on efficiency and patient care were reported. ConclusionsThe results suggest an overall positive response to EMR implementation. Minimal staff reported effects such as stress or anxiety in the workplace related to EMR implementation, and a perception of ‘comfort’ was cited once EMR was part of usual practice. However, responders did not report a significant effect on speed, efficiency or quality of patient care following EMR implementation. What is known about the topic?A growing body of literature exists regarding the perceptions of staff (particularly medical officers) in moving towards EMRs, but there is limited evidence regarding the perceptions of AHPs, and the barriers and facilitators to this change. What does this paper add?This paper presents a novel perspective regarding the perceptions of AHPs regarding the implementation of an EMR and provides a perspective of the barriers and facilitators that supported a smooth transition at three sites. What are the implications for practitioners?Despite being a large-scale service change, the introduction of an EMR did not significantly increase AHPs’ subjective feelings of anxiety. Services considering EMR implementation should invest in the provision of timely information, ‘at-elbow’ support and opportunities to practice the new system.

The role of champions in the implementation of technology in healthcare services: a systematic mixed studies review

“… Hospital Health care provider decision support Nurse champion The nurse champion was responsible for quality improvement. Schwarz et al [ 39 ], Australia Quantitative descriptive design, cross-sectional survey. Descriptive Implementation Study N = 104 104 AHPs To provide an overview of AHPs’ perceptions of EMR implementation across three sites (both regional and metropolitan), with a focus on identifying perceptions before, during, and after implementation in relation to subjective perceptions, barriers and facilitators and overall satisfaction.…”

“…Several studies underscored the importance of champions for successful implementation [ 29 – 31 , 34 – 38 , 40 – 43 , 49 ]. Four studies specifically highlighted champions as a key factor for success [ 34 , 36 , 37 , 43 ], and one study went further to describe champions as the most important factor for successful implementation [ 39 ]. Additionally, one study associated champions with reduced labor cost [ 30 ].…”

The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis

“…Of the 41 quantitative studies that investigated the clinician experience, 24 (59%) included an overall EMR satisfaction metric, and 71% (17/24) of these studies reported a positive sentiment [47,49,59,60,62,70,72,73,76,79,80,85,[87][88][89]98,101]. For instance, Kutney-Lee et al [76] used the registered nurse forecasting study (RN4CAST-US) nursing survey with 12,377 nurses across 353 hospitals and found a 74.9% "satisfaction with current EMR."…”

Understanding the Digital Disruption of Health Care: An Ethnographic Study of Real-Time Multidisciplinary Clinical Behavior in a New Digital Hospital

“…These have been delayed up to 3 years post-transformation, in siloed clinical disciplines (e.g., medical, nursing, or allied health only) or using cross-sectional survey or phenomenological (interviews/focus groups) methods. [8][9][10][11][12][13] These methods are retrospective and narrow; there is a need for real-time observation of multidisciplinary clinical team behavior during the digital disruption of health care.…”

“…These have been delayed up to 3 years post-transformation, in siloed clinical disciplines (e.g., medical, nursing, or allied health only) or using cross-sectional survey or phenomenological (interviews/focus groups) methods. 8 9 10 11 12 13 …”