Int J Med Inform - Perceived efficiency impacts following electronic health record implementation: an exploratory study of an urban community health center network.

Tópicos

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Resumo

RPOSE: Faced with an increasingly complex patient population and growing demand for services, community health centers (CHCs) are recognizing that electronic health records (EHRs) may help their efforts to improve efficiency in care delivery. Yet little is known about the benefits, challenges, and specific impacts of EHR implementation in the often resource-constrained CHC environment, especially from users' perspectives. The objective of this study was to explore EHR users' perspectives about the EHR implementation process and impact in a CHC network.METHODS: We performed an exploratory case study following EHR implementation in a multi-site, urban CHC network. Data were collected through semi-structured interviews with 39 key informants across four sites. Key informants included physicians, clinical staff and administrators. We used both deductive and inductive approaches to code the transcribed interview data and to identify themes in our analyses.RESULTS: A key theme that emerged involved perceptions of efficiency related to the EHR implementation. While the EHR was widely credited with improving the efficiency of several clinical processes (e.g., lab ordering), it also created new challenges. Some of the early efficiency challenges we identified were common to EHR implementation in general (e.g., system interface issues), but others were unique to the CHC context (e.g., issues related to compliance with complex regulatory and reporting requirements). Further, constrained organizational resources for training and ongoing IT support were widely noted as challenges that may have exacerbated, or precluded early resolution of, efficiency issues. While limited to a single CHC network, our findings highlight important issues for CHCs to consider about EHRs.CONCLUSIONS: These findings suggest that CHCs face difficult and often unique barriers related to EHR implementation and use, and the resultant efficiency impacts should not be overlooked.

Resumo Limpo

rpose face increas complex patient popul grow demand servic communiti health center chcs recogn electron health record ehr may help effort improv effici care deliveri yet littl known benefit challeng specif impact ehr implement often resourceconstrain chc environ especi user perspect object studi explor ehr user perspect ehr implement process impact chc networkmethod perform exploratori case studi follow ehr implement multisit urban chc network data collect semistructur interview key inform across four site key inform includ physician clinic staff administr use deduct induct approach code transcrib interview data identifi theme analysesresult key theme emerg involv percept effici relat ehr implement ehr wide credit improv effici sever clinic process eg lab order also creat new challeng earli effici challeng identifi common ehr implement general eg system interfac issu other uniqu chc context eg issu relat complianc complex regulatori report requir constrain organiz resourc train ongo support wide note challeng may exacerb preclud earli resolut effici issu limit singl chc network find highlight import issu chcs consid ehrsconclus find suggest chcs face difficult often uniqu barrier relat ehr implement use result effici impact overlook

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