Understanding optimisation processes of electronic health records (EHRs) in select leading hospitals: a qualitative study

Abstract

BackgroundLittle is known about optimisation of electronic health records (EHRs) systems in the hospital setting while adoption of EHR systems continues in the United States.ObjectiveTo understand optimisation processes of EHR systems undertaken in leading healthcare organisations in the United States.MethodsInformed by a grounded theory approach, a qualitative study was undertaken that involved 11 in-depth interviews and a focus group with the EHR experts from the high performing healthcare organisations across the United States.ResultsThe study describes EHR optimisation processes characterised by prioritising exponentially increasing requests with predominant focus on improving efficiency of EHR, building optimisation teams or advisory groups and standardisation. The study discusses 16 types of optimisation that interdependently produced 16 results along with identifying 11 barriers and 20 facilitators to optimisation.ConclusionsThe study describes overall experiences of optimising EHRs in select high performing healthcare organisations in the US. The findings highlight the importance of optimising the EHR after, and even before, go-live and dedicating resources exclusively for optimisation.

Empirical Evaluation of the Influence of EMR Alignment to Care Processes on Data Completeness

“…In the EMR context, a good communication between IT and clinical staff contributes to addressing mismatch problems between workflow of EMR and care processes, considering possibilities of using EMR data during care delivery [15,17]. Furthermore, EMR customization in care processes could well aggregate required data from multiple sources for different use [18][19][20]. We hypothesize:…”

“…If IT professionals improve their understanding of data needs and correct data errors by communication with users, high-quality data aggregated from different systems could have a better chance to address during IS integration [2]. Furthermore, EMR customization in care processes could help organize and collect required data for clinical decision making [18][19][20]. We hypothesize:…”

“…EMR) integrated into work processes could better consider opportunities for use of EMR data [15]. This high level of EMR integration then could facilitate use of EMR during care delivery [15,19], and thus, data completeness could be better addressed in EMR. We hypothesize:…”

Innovation to build learning health systems

“…offer an evidence synthesis of EHR implementation barriers, success factors and operational impacts. Moon et al 5. report a qualitative study of EHR optimisation in a set of US hospitals known for their advanced usage of health information technology, emphasising that in many respects the work only starts after go-live and that dedicated resources are needed to drive the optimisation of workflow, processes and practice.…”

The Electronic Health Record: A Friend or Foe of Translational Research and Evidence‐Based Practice?

“…Since our institution adopted the EHR, the terms “optimization and upgrades” have become part of our nursing vernacular. Optimization describes an ongoing process to enhance the ability of the EHR system to achieve goals with a clear focus on outcomes (Blavin, Ramos, Shah, & Devers, ; Moon, Hills, & Demiris, ). The literature abounds with evidence supporting the use of clinical decision‐making support for clinicians.…”