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Appl Clin Inform 2018; 09(03): 725-733
DOI: 10.1055/s-0038-1668553
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Emergency Physicians' Perceived Influence of EHR Use on Clinical Workflow and Performance Metrics

Courtney A. Denton
1   Center for Cognitive Studies in Medicine and Public Health, The New York Academy of Medicine, New York, New York, United States
,
Hiral C. Soni
2   Department of Biomedical Informatics, Arizona State University, Phoenix, Arizona, United States
,
Thomas G. Kannampallil
3   Department of Family Medicine, University of Illinois at Chicago, Illinois, United States
,
Anna Serrichio
1   Center for Cognitive Studies in Medicine and Public Health, The New York Academy of Medicine, New York, New York, United States
,
Jason S. Shapiro
4   Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
,
Stephen J. Traub
5   Department of Emergency Medicine, Mayo Clinic, Phoenix, Arizona, United States
,
Vimla L. Patel
1   Center for Cognitive Studies in Medicine and Public Health, The New York Academy of Medicine, New York, New York, United States
2   Department of Biomedical Informatics, Arizona State University, Phoenix, Arizona, United States
› Author Affiliations Funding This research is supported by a grant (No. R01HS022670) from the Agency for Healthcare Research and Quality (AHRQ). The content is the sole responsibility of the authors and does not necessarily represent the official views of AHRQ.
Further Information

Publication History

07 April 2018

06 July 2018

Publication Date:
12 September 2018 (online)

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Abstract

Objective Over the last decade, electronic health records (EHRs) have shaped clinical practice. In this article, we investigated the perceived effects of EHR use on clinical workflow and meaningful use (MU) performance metrics.

Materials and Methods Semistructured interviews were conducted with 20 (n = 20) physicians at two urban emergency departments. Interview questions focused on time spent on EHR use, changes in clinical practices with EHR use, and the effect of MU performance metrics on clinical workflow. Qualitative coding using grounded theory and descriptive analyses were performed to provide descriptive insights.

Results Physicians reported that EHRs improved their clinical workflow, especially on MU-related activities including door-to-doctor time and admit decision time. EHR use also affected physicians work efficiency, quality of care provided, and overall patient safety.

Conclusion Physicians' perception of EHRs is likely to influence their practices. With negative perceptions of EHR usability problems, positive aspects of EHR use, including the influence on MU performance metrics, may be overridden.

Keywords

physician perception - EHR - meaningful use - clinical performance - emergency department

Protection of Human and Animal Subjects

The institutional review board of the hospitals (Icahn School of Medicine at Mount Sinai, Mayo Clinic) and that of The New York Academy of Medicine approved this study. Written consents were obtained from all participants.


 

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