Adoption of Electronic Health Records

L. Grabenbauer; R. Fraser; J. McClay; N. Woelfl; C.B. Thompson; J. Cambell; J. Windle

doi:10.4338/ACI-2011-01-RA-0003

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2011; 02(02): 165-176
DOI: 10.4338/ACI-2011-01-RA-0003

Research Article

Schattauer GmbH

Adoption of Electronic Health Records

A Qualitative Study of Academic and Private Physicians and Health Administrators

Authors

L. Grabenbauer

¹University of Nebraska Medical Center
R. Fraser

²University of Missouri
J. McClay

¹University of Nebraska Medical Center
N. Woelfl

¹University of Nebraska Medical Center
C.B. Thompson

¹University of Nebraska Medical Center
J. Cambell

¹University of Nebraska Medical Center
J. Windle

¹University of Nebraska Medical Center

Abstract

Summary

Objective: Less than 20% of hospitals in the US have an electronic health record (EHR). In this qualitative study, we examine the perspectives of both academic and private physicians and administrators as stakeholders, and their alignment, to explore their perspectives on the use of technology in the clinical environment.

Methods: Focus groups were conducted with 74 participants who were asked a series of open-ended questions. Grounded theory was used to analyze the transcribed data and build convergent themes. The relevance and importance of themes was constructed by examining frequency, convergence, and intensity. A model was proposed that represents the interactions between themes. Results: Six major themes emerged, which include the impact of EHR systems on workflow, patient care, communication, research/outcomes/billing, education/learning, and institutional culture. Academic and private physicians were confident of the future benefits of EHR systems, yet cautious about the current implementations of EHR, and its impact on interactions with other members of the healthcare team and with patients, and the amount of time necessary to use EHR’s. Private physicians differed on education and were uneasy about the steep learning curve necessary for use of new systems. In contrast to physicians, university and hospital administrators are optimistic, and value the availability of data for use in reporting.

Conclusion: The results of our study indicate that both private and academic physicians concur on the need for features that maintain and enhance the relationship with the patient and the healthcare team. Resistance to adoption is related to insufficient functionality and its potential negative impact on patient care. Integration of data collection into clinical workflows must consider the unexpected costs of data acquisition.

Keywords

Adoption - health information technology - workflow

Full Text

References

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