Int J Med Inform - Physician experiences transitioning between an older versus newer electronic health record for electronic prescribing.

Tópicos

{ ehr(2073) health(1662) electron(1139) }
{ care(1570) inform(1187) nurs(1089) }
{ state(1844) use(1261) util(961) }
{ medic(1828) order(1363) alert(1069) }
{ age(1611) year(1155) adult(843) }
{ use(2086) technolog(871) perceiv(783) }
{ motion(1329) object(1292) video(1091) }
{ clinic(1479) use(1117) guidelin(835) }
{ cost(1906) reduc(1198) effect(832) }
{ health(1844) social(1437) communiti(874) }
{ concept(1167) ontolog(924) domain(897) }
{ howev(809) still(633) remain(590) }
{ use(976) code(926) identifi(902) }
{ extract(1171) text(1153) clinic(932) }
{ featur(1941) imag(1645) propos(1176) }
{ first(2504) two(1366) second(1323) }
{ process(1125) use(805) approach(778) }
{ imag(2675) segment(2577) method(1081) }
{ general(901) number(790) one(736) }
{ perform(999) metric(946) measur(919) }
{ gene(2352) biolog(1181) express(1162) }
{ decis(3086) make(1611) patient(1517) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ imag(1057) registr(996) error(939) }
{ method(1219) similar(1157) match(930) }
{ patient(2315) diseas(1263) diabet(1191) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ algorithm(1844) comput(1787) effici(935) }
{ design(1359) user(1324) use(1319) }
{ visual(1396) interact(850) tool(830) }
{ perform(1367) use(1326) method(1137) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ can(981) present(881) function(850) }
{ estim(2440) model(1874) function(577) }
{ method(2212) result(1239) propos(1039) }
{ model(3404) distribut(989) bayesian(671) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ case(1353) use(1143) diagnosi(1136) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ data(3008) multipl(1320) sourc(1022) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ analysi(2126) use(1163) compon(1037) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

RPOSE: Federal incentives to adopt interoperable, certified electronic health records (EHRs) with electronic prescribing (e-prescribing) are motivating providers using older EHRs to transition to newer EHRs. The objective of this study was to describe, from the perspective of experienced EHR users, the transition from an older, locally developed EHR with minimal clinical decision support (CDS) for e-prescribing to a newer, commercial EHR with more robust CDS for e-prescribing.METHODS: This qualitative, case study consisted of observations and semi-structured interviews of adult internal medicine faculty members (n=19) at an academic-affiliated ambulatory care clinic from January through November 2009. All providers transitioned from the older, locally developed EHR to the newer, commercial EHR in April 2008. We analyzed field notes of observations and transcripts of semi-structured interviews using qualitative methods guided by a grounded theory approach.RESULTS: We identified key themes describing physician experiences. Despite intensive effort by the information systems team to ease the transition, even these experienced e-prescribers found transitioning extremely difficult. The commercial EHR was not perceived as improving medication safety, despite having more robust CDS. Additionally, physicians felt the commercial EHR was too complex, reducing their efficiency.CONCLUSIONS: This is among the first studies examining physician experiences transitioning between an older, locally developed EHR to a newer, commercial EHR with more robust CDS for e-prescribing. Understanding physician experiences with this type of transition and their general preferences for prescribing applications may lead to less disruptive system implementations and better designed EHRs that are more readily accepted by providers. In this way, productivity and safety benefits may be maximized while mitigating potential threats associated with transitions.TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT00603070.

Resumo Limpo

rpose feder incent adopt interoper certifi electron health record ehr electron prescrib eprescrib motiv provid use older ehr transit newer ehr object studi describ perspect experienc ehr user transit older local develop ehr minim clinic decis support cds eprescrib newer commerci ehr robust cds eprescribingmethod qualit case studi consist observ semistructur interview adult intern medicin faculti member n academicaffili ambulatori care clinic januari novemb provid transit older local develop ehr newer commerci ehr april analyz field note observ transcript semistructur interview use qualit method guid ground theori approachresult identifi key theme describ physician experi despit intens effort inform system team eas transit even experienc eprescrib found transit extrem difficult commerci ehr perceiv improv medic safeti despit robust cds addit physician felt commerci ehr complex reduc efficiencyconclus among first studi examin physician experi transit older local develop ehr newer commerci ehr robust cds eprescrib understand physician experi type transit general prefer prescrib applic may lead less disrupt system implement better design ehr readili accept provid way product safeti benefit may maxim mitig potenti threat associ transitionstri registr clinicaltrialsgov identifi nct

Resumos Similares

J Med Syst - Factors related to health information exchange participation and use. ( 0,867299371015472 )
Inform Health Soc Care - Nurses' use of an integrated electronic health record: results of a case site analysis. ( 0,829717752746102 )
J Biomed Inform - Implementations of the HL7 Context-Aware Knowledge Retrieval (Infobutton) Standard: challenges, strengths, limitations, and uptake. ( 0,827624867390484 )
Appl Clin Inform - Electronic Health Record Adoption - Maybe It's not about the Money: Physician Super-Users, Electronic Health Records and Patient Care. ( 0,823246441475217 )
J Med Syst - Benefits and challenges of electronic health record system on stakeholders: a qualitative study of outpatient physicians. ( 0,822692555444844 )
J Biomed Inform - Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region. ( 0,800226998146809 )
AMIA Annu Symp Proc - Leveraging standards to support patient-centric interdisciplinary plans of care. ( 0,797127717291514 )
Appl Clin Inform - The impact of geography on hospital electronic health records implementation in alabama: implications for meaningful use. ( 0,79109482219224 )
Int J Med Inform - Adoption of a clinical decision support system to promote judicious use of antibiotics for acute respiratory infections in primary care. ( 0,789519981433602 )
Int J Med Inform - Adoption of electronic health records in Korean tertiary teaching and general hospitals. ( 0,786853330848589 )
J Am Med Inform Assoc - Sequencing of EHR adoption among US hospitals and the impact of meaningful use. ( 0,78552971143861 )
J Am Med Inform Assoc - Data standards to support health information exchange between poison control centers and emergency departments. ( 0,782130508058924 )
Int J Med Inform - Do integrated record systems lead to integrated services? An observational study of a multi-professional system in a diabetes service. ( 0,780449240419908 )
Healthc (Amst) - Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers. ( 0,779010843568201 )
J Am Med Inform Assoc - Evaluating and classifying the readiness of technology specifications for national standardization. ( 0,778107869981833 )
J Am Med Inform Assoc - A typology of electronic health record workarounds in small-to-medium size primary care practices. ( 0,777235679924048 )
J Am Med Inform Assoc - ICU nurses' acceptance of electronic health records. ( 0,77492307347301 )
Perspect Health Inf Manag - Health information technology: integration of clinical workflow into meaningful use of electronic health records. ( 0,773320222237906 )
Appl Clin Inform - Physician specialty and variations in adoption of electronic health records. ( 0,773319324246651 )
J Am Med Inform Assoc - When does adoption of health information technology by physician practices lead to use by physicians within the practice? ( 0,771769374130665 )
J Am Med Inform Assoc - Phased implementation of electronic health records through an office of clinical transformation. ( 0,771417743035868 )
BMC Med Inform Decis Mak - General practitioners' attitudes and preparedness towards Clinical Decision Support in e-Prescribing (CDS-eP) adoption in the West of Ireland: a cross sectional study. ( 0,769170491199116 )
J Am Med Inform Assoc - Electronic health record use and preventive counseling for US children and adolescents. ( 0,769092265660033 )
AMIA Annu Symp Proc - Progress and challenge in meeting meaningful use at an integrated delivery network. ( 0,76805622695826 )
J Am Med Inform Assoc - The Hub Population Health System: distributed ad hoc queries and alerts. ( 0,767348403779871 )
Healthc (Amst) - Meaningful use: Floor or ceiling? ( 0,766602355890537 )
Int J Med Inform - Rates, levels, and determinants of electronic health record system adoption: a study of hospitals in Riyadh, Saudi Arabia. ( 0,76640773963528 )
J Am Med Inform Assoc - Exploring the sociotechnical intersection of patient safety and electronic health record implementation. ( 0,766133765863574 )
J Am Med Inform Assoc - The use of open source electronic health records within the federal safety net. ( 0,765506093584458 )
J Biomed Inform - Content overlap in nurse and physician handoff artifacts and the potential role of electronic health records: a systematic review. ( 0,764996057368811 )
Healthc (Amst) - A novel community-based delivery model to combat cancer disparities. ( 0,762985895912193 )
J Am Med Inform Assoc - Consumer experience with and attitudes toward health information technology: a nationwide survey. ( 0,762882093080187 )
Methods Inf Med - Why the hell do we need electronic health records?. EHR acceptance among physicians in private practice in Austria: a qualitative study. ( 0,762196274992943 )
AMIA Annu Symp Proc - Assessing readiness for meeting meaningful use: identifying electronic health record functionality and measuring levels of adoption. ( 0,762007708866151 )
Perspect Health Inf Manag - Hospital characteristics related to the intention to apply for meaningful use incentive payments. ( 0,759006365153217 )
Comput Methods Programs Biomed - The relationship between usage intention and adoption of electronic health records at primary care clinics. ( 0,757165249232711 )
Appl Clin Inform - Predictors of success for electronic health record implementation in small physician practices. ( 0,754586838403047 )
Appl Clin Inform - Adoption of electronic health records: a qualitative study of academic and private physicians and health administrators. ( 0,753276421045328 )
J Med Syst - Organization's quality maturity as a vehicle for EHR success. ( 0,751501756741939 )
Int J Med Inform - Contingency planning for electronic health record-based care continuity: a survey of recommended practices. ( 0,750862707026776 )
Inform Health Soc Care - Attitudes of health professionals towards electronic health records in primary health care settings: a questionnaire survey. ( 0,750686371925829 )
Perspect Health Inf Manag - Electronic health record adoption and use by Nebraska pharmacists. ( 0,750101818565207 )
J Biomed Inform - Translating standards into practice: experience and lessons learned at the Department of Veterans Affairs. ( 0,748047673815005 )
BMC Med Inform Decis Mak - A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review. ( 0,747950381359723 )
Int J Med Inform - Health information exchange in small-to-medium sized family medicine practices: motivators, barriers, and potential facilitators of adoption. ( 0,743840301531517 )
J Am Med Inform Assoc - Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative. ( 0,742212019655735 )
Perspect Health Inf Manag - EHR acceptance factors in ambulatory care: a survey of physician perceptions. ( 0,742209884827226 )
Health Info Libr J - Do quality improvement systems improve health library services? A systematic review. ( 0,737226016995353 )
J Am Med Inform Assoc - Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies. ( 0,735119298784123 )
Perspect Health Inf Manag - Use of health information technology by office-based physicians: comparison of two contemporaneous public-use physician surveys. ( 0,734812161681116 )
Appl Clin Inform - Lessons Learned from Implementation of Information and Communication Technologies in Spain's Healthcare Services: Issues and Opportunities. ( 0,734778990105469 )
J Am Med Inform Assoc - Implications of an emerging EHR monoculture for hospitals and healthcare systems. ( 0,733629210631762 )
J Am Med Inform Assoc - Electronic health record functionality needed to better support primary care. ( 0,731284322961912 )
Appl Clin Inform - Utilizing an electronic health record system to improve vaccination coverage in children. ( 0,730464687736168 )
Appl Clin Inform - Capturing information needs of care providers to support knowledge sharing and distributed decision making. ( 0,729913847268408 )
AMIA Annu Symp Proc - The EHR's roles in collaboration between providers: A qualitative study. ( 0,726755074808046 )
BMC Med Inform Decis Mak - Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers. ( 0,726410810964522 )
AMIA Annu Symp Proc - The promise of the CCD: challenges and opportunity for quality improvement and population health. ( 0,725624442983616 )
Int J Med Inform - The implementation of electronic health records: a case study of bush computing the Ngaanyatjarra lands. ( 0,725398853251121 )
Telemed J E Health - New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain. ( 0,724996586940351 )
J Am Med Inform Assoc - Health-information exchange: why are we doing it, and what are we doing? ( 0,723831976100005 )
J Am Med Inform Assoc - Factors associated with difficult electronic health record implementation in office practice. ( 0,722994573739476 )
AMIA Annu Symp Proc - Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation. ( 0,722696598068869 )
Healthc (Amst) - Health information exchange among U.S. hospitals: who's in, who's out, and why? ( 0,719698905137601 )
AMIA Annu Symp Proc - Implementing the IT infrastructure for health reform: adoption of health IT among patient-centered medical home practices. ( 0,719555380746859 )
AMIA Annu Symp Proc - Bridging informatics and implementation science: evaluating a framework to assess electronic health record implementations in community settings. ( 0,718967478840336 )
J Am Med Inform Assoc - Organizational complements to electronic health records in ambulatory physician performance: the role of support staff. ( 0,715961420953782 )
J Med Syst - EHR implementation in a new clinic: a case study of clinician perceptions. ( 0,715622811873913 )
AMIA Annu Symp Proc - Health information exchange, Health Information Technology use, and hospital readmission rates. ( 0,71557590432612 )
BMC Med Inform Decis Mak - Has information technology finally been adopted in Flemish intensive care units? ( 0,71518260820289 )
Int J Med Inform - Collaboration in electronic medical evidence development: a case study of the Social Security Administration's MEGAHIT System. ( 0,712765790837888 )
J Am Med Inform Assoc - Same organization, same electronic health records (EHRs) system, different use: exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting. ( 0,71263156579345 )
J Med Syst - A review of analytics and clinical informatics in health care. ( 0,71221800184322 )
Int J Med Inform - Model development for EHR interdisciplinary information exchange of ICU common goals. ( 0,709458938748204 )
J Med Syst - Challenges, alternatives, and paths to sustainability for health information exchange efforts. ( 0,70872563797491 )
J Am Med Inform Assoc - Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. ( 0,708655363513987 )
J Med Syst - A basic study on application of voice recognition input to an electronic nursing record system -evaluation of the function as an input interface-. ( 0,708265756089848 )
J Am Med Inform Assoc - How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use. ( 0,707399519222068 )
Appl Clin Inform - Diffusion of Electronic Health Records and electronic communication in Norway. ( 0,705959280293608 )
J Med Syst - Emergency healthcare process automation using mobile computing and cloud services. ( 0,705847611360076 )
J Med Syst - EHR systems in the Spanish Public Health National System: the lack of interoperability between primary and specialty care. ( 0,705470918237218 )
J Med Syst - Threat modeling for electronic health record systems. ( 0,703191775553671 )
J Am Med Inform Assoc - Patient safety goals for the proposed Federal Health Information Technology Safety Center. ( 0,700849949304505 )
J Am Med Inform Assoc - Validity of electronic health record-derived quality measurement for performance monitoring. ( 0,700362895422634 )
Int J Med Inform - Transitioning from a computerized provider order entry and paper documentation system to an electronic health record: expectations and experiences of hospital staff. ( 0,697548162782089 )
J Med Syst - Factors associated with health information exchange system usage in a safety-net ambulatory care clinic setting. ( 0,697230800967459 )
Methods Inf Med - Semantic validation of standard-based electronic health record documents with W3C XML schema. ( 0,696065846591782 )
AMIA Annu Symp Proc - Adoption of clinical data exchange in community settings: a comparison of two approaches. ( 0,696024748281026 )
Perspect Health Inf Manag - Leveraging the cloud for electronic health record access. ( 0,695994553718031 )
J Am Med Inform Assoc - Blue Button use by patients to access and share health record information using the Department of Veterans Affairs' online patient portal. ( 0,695901904024131 )
J Biomed Inform - Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data: the SHARPn project. ( 0,694203657339784 )
Healthc (Amst) - EHR adopters vs. non-adopters: Impacts of, barriers to, and federal initiatives for EHR adoption. ( 0,693056509178784 )
J Am Med Inform Assoc - The marginal value of pre-visit paper reminders when added to a multifaceted electronic health record based quality improvement system. ( 0,690690612709905 )
Appl Clin Inform - Transitioning from a legacy EHR to a commercial, vendor-supplied, EHR: one academic health system's experience. ( 0,688102515373763 )
J Am Med Inform Assoc - Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department. ( 0,687574414819822 )
Int J Med Inform - The IT productivity paradox in health: a stakeholder's perspective. ( 0,687573229070828 )
AMIA Annu Symp Proc - Impacts of EHR Certification and Meaningful Use Implementation on an Integrated Delivery Network. ( 0,68696775857131 )
AMIA Annu Symp Proc - Cross-mapping clinical notes between hospitals: an application of the LOINC Document Ontology. ( 0,686604503659729 )
J Am Med Inform Assoc - Let the left hand know what the right is doing: a vision for care coordination and electronic health records. ( 0,684102295185755 )
J Am Med Inform Assoc - The long-term financial impact of electronic health record implementation. ( 0,683538731833603 )