Usage Pattern Differences and Similarities of Mobile Electronic Medical Records Among Health Care Providers

Abstract

BackgroundRecently, many hospitals have introduced mobile electronic medical records (mEMRs). Although numerous studies have been published on the usability or usage patterns of mEMRs through user surveys, investigations based on the real data usage are lacking.ObjectiveAsan Medical Center, a tertiary hospital in Seoul, Korea, implemented an mEMR program in 2010. On the basis of the mEMR usage log data collected over a period of 4.5 years, we aimed to identify a usage pattern and trends in accordance with user occupation and to disseminate the factors that make the mEMR more effective and efficient.MethodsThe mEMR log data were collected from March 2012 to August 2016. Descriptive analyses were completed according to user occupation, access time, services, and wireless network type. Specifically, analyses targeted were as follows: (1) the status of the mEMR usage and distribution of users, (2) trends in the number of users and usage amount, (3) 24-hour usage patterns, and (4) trends in service usage based on user occupations. Linear regressions were performed to model the relationship between the time, access frequency, and the number of users. The differences between the user occupations were examined using Student t tests for categorical variables.ResultsApproximately two-thirds of the doctors and nurses used the mEMR. The number of logs studied was 7,144,459. Among 3859 users, 2333 (60.46%) users were nurses and 1102 (28.56%) users were doctors. On average, the mEMR was used 1044 times by 438 users per day. The number of users and amount of access logs have significantly increased since 2012 (P<.001). Nurses used the mEMR 3 times more often than doctors. The use of mEMR by nurses increased by an annual average of 51.5%, but use by doctors decreased by an annual average of 7.7%. For doctors, the peak usage periods were observed during 08:00 to 09:00 and 17:00 to 18:00, which were coincident with the beginning of ward rounds. Conversely, the peak usage periods for the nurses were observed during 05:00 to 06:00, 12:00 to 13:00, and 20:00 to 21:00, which effectively occurred 1 or 2 hours before handover. In more than 80% of all cases, the mEMR was accessed via a nonhospital wireless network.ConclusionsThe usage patterns of the mEMR differed between doctors and nurses according to their different workflows. In both occupations, mEMR was highly used when personal computer access was limited and the need for patient information was high, such as during ward rounds or handover periods.

A Scoping Review of the Use of Log Data for Evaluating Mobile Apps: Exploring Implications for mHealth Apps

“…For effective evaluations, benchmarks or thresholds are required for comparability to determine whether the results are desirable or not and what could be improved. [36] state that there are no scales or standard measures for assessing the findings' relevance or comparing similar interventions and their results. This literature review confirmed this statement as no policies, standards, or set benchmarks were used to conduct or compare the log analysis findings.…”

“…9. User groups were identified according to the time-based [26,267,36], location-based [27,37], or device-based [27,[36][37][38]] frequency of usage. The time-based usage can be grouped into three main user groups according to the frequency of use: Active users (high-usage frequency), occasional users (medium or low usage frequency) and inactive users (nonusage), as summarized by Table 5.…”

The Association Between Using a Mobile Version of an Electronic Health Record and the Well-Being of Nurses: Cross-sectional Survey Study

“…Viewing electronic health records (EHRs) on mobile devices such as tablets and smartphones has increased lately and is becoming more common in the health care sector in many developed countries. Nurses form the largest group in health care that uses EHRs and their mobile versions [ 1 ]. A previous study reported that use of mobile versions of EHR is common in hospitals, especially during the handover period and ward hours [ 1 ].…”

“…Nurses form the largest group in health care that uses EHRs and their mobile versions [ 1 ]. A previous study reported that use of mobile versions of EHR is common in hospitals, especially during the handover period and ward hours [ 1 ]. Nurses have been found to use the mobile version of EHR mainly for viewing inpatient lists, nursing notes, alerts, and patients’ clinical data with high frequency [ 2 ].…”

Variability in Doctors’ Usage Paths of Mobile Electronic Health Records Across Specialties: Comprehensive Analysis of Log Data

“…Recently, efforts have been made to analyze log data from mEHRs for the evaluation of providers’ workflow [14,15]. Even among doctors, the usage paths are likely to differ according to their specialties, resulting in different work processes [13].…”