Appl Clin Inform - Adoption of electronic health records: a qualitative study of academic and private physicians and health administrators.

Tópicos

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Resumo

JECTIVE: 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.

Resumo Limpo

jectiv less hospit us electron health record ehr qualit studi examin perspect academ privat physician administr stakehold align explor perspect use technolog clinic environmentmethod focus group conduct particip ask seri openend question ground theori use analyz transcrib data build converg theme relev import theme construct examin frequenc converg intens model propos repres interact themesresult six major theme emerg includ impact ehr system workflow patient care communic researchoutcomesbil educationlearn institut cultur academ privat physician confid futur benefit ehr system yet cautious current implement ehr impact interact member healthcar team patient amount time necessari use ehr privat physician differ educ uneasi steep learn curv necessari use new system contrast physician univers hospit administr optimist valu avail data use reportingconclus result studi indic privat academ physician concur need featur maintain enhanc relationship patient healthcar team resist adopt relat insuffici function potenti negat impact patient care integr data collect clinic workflow must consid unexpect cost data acquisit

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