Summary
Objectives: To evaluate the use, usability, and physician satisfaction of a locally developed
problem-oriented clinical notes application that replaced paper-based records in a
large Dutch university medical center.
Methods: Using a clinical notes database and an application event log file and a cross-sectional
survey of usability, authors retrospectively analyzed system usage for medical specialties,
users, and patients over 4 years. A standardized questionnaire measured usability.
Authors analyzed the effects of sex, age, professional experience, training hours,
and medical specialty on user satisfaction via univariate analysis of variance. Authors
also examined the correlation between user satisfaction in relation to users’ intensity
of use of the application.
Results: In total 1,793 physicians used the application to record progress notes for 219,755
patients. The overall satisfaction score was 3.2 on a scale from 1 (highly dissatisfied)
to 5(highly satisfied). A statistically significant difference occurred in satisfaction
by medical specialty, but no statistically significant differences in satisfaction
took place by sex, age, professional experience, or training hours. Intensity of system
use did not correlate with physician satisfaction.
Conclusions: By two years after the start of the implementation, all medical specialties utilized
the clinical notes application. User satisfaction was neutral (3.2 on a 1–5 scale).
Authors believe that the significant factors facilitating this transition mirrored
success factors reported by other groups: a generic, consistent, and transparent design
of the application; intensive collaboration; continuous monitoring; and an incremental
rollout.
Citation: Cillessen FHJM, de Vries Robbé PF, Biermans MCJ. A hospital-wide transition from
paper to digital problem-oriented clinical note. Appl Clin Inform 2017; 8: 502–514
https://doi.org/10.4338/ACI-2016-08-RA-0137
Keywords
Electronic health records and systems - problem-oriented medical records - evaluation
- satisfaction - physician