Structured Data Entry in the Electronic Medical Record: Perspectives of Pediatric Specialty Physicians and Surgeons

  • Ruth A. Bush
  • Cynthia Kuelbs
  • Julie Ryu
  • Wen Jiang
  • George Chiang
Systems-Level Quality Improvement
Part of the following topical collections:
  1. Systems-Level Quality Improvement


The Epic electronic health record (EHR) platform supports structured data entry systems (SDES), which allow developers, with input from users, to create highly customized patient-record templates in order to maximize data completeness and to standardize structure. There are many potential advantages of using discrete data fields in the EHR to capture data for secondary analysis and epidemiological research, but direct data acquisition from clinicians remains one of the largest obstacles to leveraging the EHR for secondary use. Physician resistance to SDES is multifactorial. A 35-item questionnaire based on Unified Theory of Acceptance and Use of Technology, was used to measure attitudes, facilitation, and potential incentives for adopting SDES for clinical documentation among 25 pediatric specialty physicians and surgeons. Statistical analysis included chi-square for categorical data as well as independent sample t-tests and analysis of variance for continuous variables. Mean scores of the nine constructs demonstrated primarily positive physician attitudes toward SDES, while the surgeons were neutral. Those under 40 were more likely to respond that facilitating conditions for structured entry existed as compared to the two older age groups (p = .02). Pediatric surgeons were significantly less positive than specialty physicians about SDES effects on Performance (p = .01) and the effect of Social Influence (p = .02); but in more agreement that use of forms was voluntary (p = .02). Attitudinal differences likely reflect medical training, clinical practice workflows, and division specific practices. Identified resistance indicate efforts to increase SDES adoption should be discipline-targeted rather than a uniform approach.


Electronic health records Health information technology Pediatrics Physicians Survey 



This project was supported in part by grant number K99/R00 HS022404 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Ruth A. Bush
    • 1
    • 2
  • Cynthia Kuelbs
    • 3
  • Julie Ryu
    • 3
  • Wen Jiang
    • 4
  • George Chiang
    • 5
  1. 1.Beyster Institute for Nursing ResearchUniversity of San DiegoSan DiegoUSA
  2. 2.Clinical InformaticsRady Children’s HospitalSan DiegoUSA
  3. 3.Department of PediatricsUniversity of CaliforniaSan DiegoUSA
  4. 4.Department of SurgeryUniversity of CaliforniaSan DiegoUSA
  5. 5.Rady Children’s Institute of Genomic MedicineSan DiegoUSA

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