Trends in Primary Care Clinician Perceptions of a New Electronic Health Record
- 445 Downloads
Clinician perceptions of a newly implemented electronic health record play an important role in its success or failure.
To measure changes in primary care clinician attitudes toward an electronic health record during the first year following implementation.
86 primary care clinicians surveyed between December 2006 and January 2008.
Perceived impact on overall quality of care, patient safety, communication, and efficiency at 1, 3, 6, and 12 months following implementation.
Response rates for months 1, 3, 6, and 12 were 92%, 95%, 90%, and 82%, respectively. The proportion of clinicians agreeing that the EHR improved the overall quality of care (63% to 86%; p < 0.001), reduced medication-related errors (72% to 81%; p = 0.03), improved follow-up of test results (62% to 87%; p < 0.001), and improved communication among clinicians (72% to 93%; p < 0.001) increased from month 1 to month 12. During the same time period, a decreasing proportion of clinicians agreed that the EHR reduced the quality of patient interactions (49% to 33%; p = 0.001), resulted in longer patient visits (68% to 51%; p = 0.001), and increased time spent on medical documentation (78% to 68%; p = 0.006). Significant improvements in perceptions related to test result follow-up were first detected at 6 months, while those related to overall quality, efficiency, and communication were first identified at 12 months.
Primary care clinicians report increasingly positive perceptions of a new electronic health record within 1 year of implementation across a spectrum of domains of care.
KEY WORDSquality improvement electronic medical record electronic health record health information technology
This study was funded by grants from the Agency for Healthcare Research and Quality (1 R01 HS 015226-01) and the National Library of Medicine (2 T15 LM 07092-16). These funding agencies played no role in the conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The authors would like to thank the clinicians of Atrius Health for participating in this study. Dr. Sequist had full access to all the data in the study and takes responsibility for the integrity and the accuracy of the data analysis.
Conflict of Interest
Dr. Sequist serves as a consultant on the Aetna External Advisory Committee for Racial and Ethnic Equality.
- 14.Simon SR, Kaushal R, Cleary PD, et al. Correlates of Electronic Health Record Adoption in Office Practices: A Statewide Survey. J Am Med Inform Assoc. 2006.Google Scholar
- 20.Connolly C. Cedars-Sinai Doctors Cling to Pen and Paper. Washington Post. March 21, 2005: A01.Google Scholar
- 21.Sequist TD, Cullen T, Hays H, Taualii MM, Simon SR, Bates DW. Implementation and Use of an Electronic Health Record Within the Indian Health Service. J Am Med Inform Assoc. 2007.Google Scholar
- 32.Gadd CS, Penrod LE. Assessing physician attitudes regarding use of an outpatient EMR: a longitudinal, multi-practice study. Proc AMIA Symp. 2001:194–8.Google Scholar
- 33.Gamm LD, Barsukiewicz CK, Dansky KH, Vasey JJ, Bisordi JE, Thompson PC. Pre- and post-control model research on end-users’ satisfaction with an electronic medical record: preliminary results. Proc AMIA Symp. 1998:225–9.Google Scholar
- 34.Joos D, Chen Q, Jirjis J, Johnson KB. An electronic medical record in primary care: impact on satisfaction, work efficiency and clinic processes. AMIA Annu Symp Proc. 2006:394–8.Google Scholar
- 36.Kaelber D, Greco P, Cebul RD. Evaluation of a commercial electronic medical record (EMR) by primary care physicians 5 years after implementation. AMIA Annu Symp Proc. 2005:1002.Google Scholar
- 38.Krall MA. Acceptance and performance by clinicians using an ambulatory electronic medical record in an HMO. Proc Annu Symp Comput Appl Med Care. 1995:708–11.Google Scholar
- 39.Chin HL, McClure P. Evaluating a comprehensive outpatient clinical information system: a case study and model for system evaluation. Proc Annu Symp Comput Appl Med Care. 1995:717–21.Google Scholar