J Am Med Inform Assoc - Transitioning between ambulatory EHRs: a study of practitioners' perspectives.

Tópicos

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Resumo

JECTIVE: To evaluate practitioners' expectations of, and satisfaction with, older and newer electronic health records (EHRs) after a transition.MATERIAL AND METHODS: Pre- and post-transition survey administered at six academic-affiliated ambulatory care practices from 2006 to 2008. Four practices transitioned to one commercial EHR and two practices to another. We compared respondents' expectations of, and satisfaction with, the newer EHR.RESULTS: 523 subjects were eligible: 217 were available before transition and 306 after transition. 162 pre-transition and 197 post-transition responses were received, yielding 75% and 64% response rates, respectively. Practitioners were more satisfied with the newer EHRs (64%) compared with the older (56%) (p=0.15) and a small majority (58%) were satisfied with the transition. Practitioners' satisfaction with the older EHRs for completing clinical tasks was high. The newer EHRs exceeded practitioner expectations regarding remote access (61% vs 74%; p=0.03). However, the newer EHRs did not meet practitioners' expectations regarding their ability to perform clinical tasks, or more globally, improve medication safety (81% vs 61%; p<0.001), efficiency (70% vs 44%; p<0.001), and quality of care (77% vs 67%; p=0.04).DISCUSSION: Most practitioners had favorable opinions about EHRs and reported overall improved satisfaction with the newer EHRs. However, practitioners' high expectations of the newer EHRs were often unmet regarding facilitation of specific clinical tasks or for improving quality, safety, and efficiency.CONCLUSION: To ensure practitioners' expectations, for instance regarding improvements in medication safety, are met, vendors should develop and implement refinements in their software as practices upgrade to newer, certified EHRs.

Resumo Limpo

jectiv evalu practition expect satisfact older newer electron health record ehr transitionmateri method pre posttransit survey administ six academicaffili ambulatori care practic four practic transit one commerci ehr two practic anoth compar respond expect satisfact newer ehrresult subject elig avail transit transit pretransit posttransit respons receiv yield respons rate respect practition satisfi newer ehr compar older p small major satisfi transit practition satisfact older ehr complet clinic task high newer ehr exceed practition expect regard remot access vs p howev newer ehr meet practition expect regard abil perform clinic task global improv medic safeti vs p effici vs p qualiti care vs pdiscuss practition favor opinion ehr report overal improv satisfact newer ehr howev practition high expect newer ehr often unmet regard facilit specif clinic task improv qualiti safeti efficiencyconclus ensur practition expect instanc regard improv medic safeti met vendor develop implement refin softwar practic upgrad newer certifi ehr

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