One study reported no notable improvements in physicians ratings for their EHRs between the years 2010 and 2014 in Finland. Further studies should evaluate the impact of changes in physician Patient-Perceived Facilitators of and Barriers to Electronic Portal Use: A Systematic Review. Another observation was that the use of definitions of EHR varied from study to study and did not comply with definitions given by ISO/TR 14639-1:2012(en) and ISO/TR 14292:2012(en). The impact of electronic health record systems on clinical Moreover, continuity of care was raised as a related aspect [33,47]. long-term financial impact of electronic health record implementation screened the abstracts. Perceived Barriers and Drivers of Health Information Systems Adoption by Public Hospitals in Alhasa; Proceedings of the 2018 21st Saudi Computer Society National Computer Conference (NCC); Riyadh, Saudi Arabia. As a result of the inadequacies of paper-based health records gradually becoming evident to the healthcare industry [3], electronic records have continued to be developed and envisioned with many expected benefits over the past 25 years. Walker J., Leveille S., Bell S., Chimowitz H., Dong Z., Elmore J.G., Fernandez L., Fossa A., Gerard M., Fitzgerald P., et al. Perceptions of impact of electronic health records on nurses work. Double/multiple documentation in different systems or double-checks for multiple resources were required to ensure that the information was correct, communicated and/or exchanged [44,96,113,148]. The research report shows that there is an impact of EHR on nurses' time reported that using computers in hospitals was significantly associated with time saved for nurses that could be. In: Siuly S., Lee I., Huang Z., Zhou R., Wang H., Xiang W., editors. Zlabek J.A., Wickus J.W., Mathiason M.A. The fact that facilitators of implementation were not included in the review may be regarded a limitation, as this could help future implementation projects on how to facilitate the implementation work more than merely being aware of potential barriers. Creber R.M.M., Grossman L.V., Ryan B., Qian M., Polubriaginof F.C.G., Restaino S., Bakken S., Hripcsak G., Vawdrey D.K. Kruse C.S., Kristof C., Jones B., Mitchell E., Martinez A. A systematic review on quality requirements. Efforts to improve these deficiencies could be of great value to academia, industry and society. Weak findings were indicated in [135], as only 17% of participants agreed with the impact of increased workload post-EHR implementation, despite the majority anticipating a negative impact on workload pre-implementation. and N.D. designed the study. Gerber D.E., Beg M.S., Duncan T., Gill M., Lee S.J.C. However, our knowledge of how EHRs actually affect collaborative practices is limited. Two additional researchers (S.F. One study showed that the proportion of clinicians who agreed that EHRs improved quality of care increased significantly (p < 0.001) from 63% at month 1 post-EHR implementation to 86% at month 12 post-EHR implementation [25]. HHS Vulnerability Disclosure, Help Author Affiliations: Fleming Centre for Healthcare Management (Mr Abbass) and School of Public Health, University of Texas (Mr Helton), and Division of Pharmacy Administration and Public Health, Department of Clinical Sciences and Administration, University of Houston, College of Pharmacy (Ms Mhatre and Dr Sansgiry), Houston, TX. Although the benefits of EHR are well-received and Health Information Technology for Economic and Clinical Health (HITECH) Act encourages the use of EHR to improve care quality and efficiency, prior studies show mixed results of implementing EHR. Yontz L.S., Zinn J.L., Schumacher E.J. However, the number of comments addressing dissatisfaction with data completeness and correctness decreased by half from time one (11 months post-EHR implementation) to time two (17 months post-EHR) in follow-up interview sessions [40]. Blijleven V., Koelemeijer K., Jaspers M. Identifying and eliminating inefficiencies in information system usage: A lean perspective. Perceived efficiency impacts following electronic health record implementation: An exploratory study of an urban community health center network. Hospital financial position and the adoption of electronic health records. Yeung T. Local health department adoption of electronic health records and health information exchanges and its impact on population health. 3 Recent studies suggest that full adoption of EHR might not be sufficient to ensure the benefits of. 14 Citations 3 Altmetric Metrics Abstract Background One of the main objectives of Electronic Health Records (EHRs) is to enhance collaboration among healthcare professionals. As the use of electronic health records increases, it becomes necessary to address their global impact on nurses productivity in hospitals. 2. In another study, participants (nurses and aged care staff) reported the convenience of data storage, as digital records in EHRs were stored on servers with backup [42]. In addition to the fact that this review did not contain a quality analysis of the included papers, a lack of uniformity in the use of definitions of EHRs, and a lack of detailed contextual information concerning the study settings could be observed. Bethesda, MD 20894, Web Policies Goetz Goldberg D., Kuzel A.J., Feng L.B., DeShazo J.P., Love L.E. Impact of electronic health record technology on the work and workflow In the early 1990s, a trend in the shift from paper-based health records to electronic records started; this was in response to advances in technology as well as the advocacy of the Institute of Medicine in the United States [1,2]. Two sources of data were linked and analyzed for years 2007 and 2008: the American Hospital Association survey and the Centers for Medicare & Medicaid Services data. Safran C., Bloomrosen M., Hammond W.E., Labkoff S., Markel-Fox S., Tang P.C., Detmer D.E. Federal government websites often end in .gov or .mil. G.W. One study showed that the survey respondents (clinicians) were dissatisfied with the usability of EHRs at both months 11 and 17 post-EHR implementation (mean score 2.1 and 2.4 out of 5) [40]. Primary care physicians spent more than one-half of their workday, nearly six hours, interacting with EHRs during and after clinic hours [152]. Satisfaction of health-care providers with electronic health records and perceived barriers to its implementation in the United Arab Emirates. Kaipio J., Lveri T., Hyppnen H., Vainiomki S., Reponen J., Kushniruk A., Borycki E., Vnsk J. Usability problems do not heal by themselves: National survey on physicians experiences with EHRs in Finland. Great challenges for clinicians as end users of EHRs exist, which restricts their potential to facilitate both the work of clinicians and the improvement of patient care quality [13]. In another survey, dissatisfaction with the completeness and correctness of data was expressed by clinicians [40]. One study showed that EHR adoption did not significantly change the amount of time specialist physicians spent with each patient [21]. Strudwick G., Hall L.M., Nagle L., Trbovich P. Acute care nurses perceptions of electronic health record use: A mixed method study. An observational study, combining data analysis of EHR usage, suggested that clinicians completed their notes sooner post-EHR implementation (mean hours to completion 1024 h) compared to the pre-EHR period (6001200 h) [50]. Whether the use of EHRs improves efficiency (i.e., saves time) for clinicians or not is still regarded as controversial [2]. Impact of Electronic Health Records on Long-Term Care Facilities: Systematic Review. Clinicians and staff also mentioned improved efficiency through the quick retrieval of information in EHRs [20,28,42,43,44,45] and a reduction in documentation time [18,34,49,59] by, for example, using EHR templates [34]. the contents by NLM or the National Institutes of Health. The use of templates in EHRs was mentioned as being beneficial [45] and saved time on documentation [34]. Key Points. Khairat S., Burke G., Archambault H., Schwartz T., Larson J., Ratwani R.M. In a longitudinal survey [25], the proportion of clinicians that agreed that communication had improved among clinicians increased from 72% to 93% (p < 0.001) over time (month 1 to month 12) following EHR implementation. The benefits of electronic health records include: Better health care by improving all aspects of patient care, including safety, effectiveness, patient-centeredness, communication, education, timeliness, efficiency, and equity. In multivariate analyses, more computerized hospitals had a slightly better quality. Nevertheless, the choice of search terms, with the omission of electronic medical record, as well as using challenges and disadvantages but omitting barriers, may have resulted in limited coverage of articles. Impact of Electronic Health Records on Nurses' Productivity I. Abbass, J. Helton, +1 author S. Sansgiry Published 1 May 2012 Medicine CIN: Computers, Informatics, Nursing As the use of electronic health records increases, it becomes necessary to address their global impact on nurses' productivity in hospitals. Poor integration of workflows involving different care professionals and poor connectivity with other healthcare organizations in EHRs could result in an increased workload for providers [29,44,141]. They have been introduced in many different settings, including low- and middle-income countries, yet little is known of the progress and effectiveness of similar information systems within Asia. However, one study compared PHR-adopting patients and non-adopters and suggested no significant effect on patient safety measures [121]. The increased organization of work after EHR implementation was raised by clinicians and staff [20,28,38,91]. What Is the Impact of an EHR on Nurses' Productivity? Meyerhoefer C.D., Sherer S.A., Deily M.E., Chou S.Y., Guo X.H., Chen J., Sheinberg M., Levick D. Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems. Patient Portal Service: An Exploration of Patients Experience and Perception; Proceedings of the ICDS 2017: The Eleventh International Conference on Digital Society; Nice, France. As the use of electronic health records increases, it becomes necessary to address their global impact on nurses' productivity in hospitals. Institute of MedicineCommittee on Improving the Patient Record . Osop H., Sahama T. Doctors perception of the potential of EHR: A Singapore insight; Proceedings of the Australasian Computer Science Week Multiconference; Brisbane, Australia. Another study found that patients preventive health behaviors were significantly associated with PHR use [80]. The impact of electronic health record use on physician productivity Continuing progress on standards for EHR data has strengthened the capability of data exchange, the secondary use of data and decision support [2,12]. Would you like email updates of new search results? Impact of Electronic Health Records on Nurses' Productivity MeSH Study participants were mainly physicians followed by registered nurses/nurse practitioners (Table 2). Robinson S., Reed M., Quevillon T., Hirvi E. Patient perceptions and interactions with their web portal-based laboratory results. The study findings fail to suggest any financial savings or superior productivity in nurses due to usage of electronic health records. Powell K.R. One study found that the majority of responding physicians (81%) reported improved remote access to patient records [46]. 2014 Dec 15;7(1):315-21. doi: 10.5539/gjhs.v7n1p315. Hertzum M., Simonsen J. Mixed effects were reported in one study as nurses and physicians experiences on EHR appeared to vary by EHR brand and employment sector [155]. Strategies for EHR implementation should be therefore recommended and promoted. Witry M.J., Doucette W.R., Daly J.M., Levy B.T., Chrischilles E.A. Consumer-Centered Computer-Supported Care for Healthy People. The influence of electronic health record use on collaboration among Asan O., Nattinger A.B., Gurses A.P., Tyszka J.T., Yen T.W.F. Please enable scripts and reload this page. Compared to the average score at baseline, which was measured before the implementation of the EHR, the average scores collected at both the first and the fifth shifts after the launch and use of EHR had increased by 15% [54]. consequences. Still, in one study, the proportion of clinicians who agreed that EHRs improved access to clinical information remained stable (between 92 and 95%) from month 1 to month 12 post-EHR implementation [25]. Synthesizing and communicating information at the individual and team levels are known drivers of patient safet All rights reserved. Specific EHR features such as alerts, reminders and minimum required data entries were reported to help clinicians notice critical laboratory values, prevent errors and improve patient safety [28,46,48]. Raglan G.B., Margolis B., Paulus R.A., Schulkin J. 68 November 2017; pp. Barbarito F., Pinciroli F., Barone A., Pizzo F., Ranza R., Mason J., Mazzola L., Bonacina S., Marceglia S. Implementing the lifelong personal health record in a regionalised health information system: The case of Lombardy, Italy. . Complaints concerning poor interoperability and integration between systems were found; these issues hindered both the implementation [48,61,93,98] and the adoption/use of EHRs and PHRs [44,47,51,56,134]. The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article. 16. One study reported increased revenues and reimbursements after the implementation of EHRs [55]. According to ISO/TR 14639-1:2012(en), an electronic medical record (EMR) is defined as an electronic record of an individual in a physicians office or clinic, which is typically in one setting and is provider-centric, whereas an electronic patient record (EPR) is defined as an electronic record of an individual in a hospital or health care facility, which is typically in one organization and is facility-centric [5]. One study showed a reduction in long-term practice productivity post-EHR implementation across all specialities in the ambulatory practice context [55], while another found that the average number of task occurrences per hour for attending physicians decreased significantly from 138 to 106 (p < 0.01; i.e., from 2.30 to 1.76 activities per minute) following an EHR implementation [53]. Negative effects of EHRs on work life balance/physician burnout were reported [127]. Stevenson JE, Nilsson GC, Petersson GI, Johansson PE. Full-text articles were excluded with reasons, including meeting the exclusion criteria; investigating partial components of EHRs (e.g., e-prescription and decision support); focusing on system development models/methods, strategic/design recommendations, design prototypes, and usability principles; reporting speculations about success factors, prevalence of use, user group characteristics and differences, workflows, and processes of implementation. Personal health records: A scoping review. Usability [32] such as the design of user interface [29,32,138] and navigation [48] were agreed to be critical features. The Digitization of Patient Care: A Review of the Effects of Electronic Data overflow was reported to be an issue resulting from free text fields in EHRs [48]. FOIA Get new journal Tables of Contents sent right to your email inbox, Impact of Electronic Health Records on Nurses Productivity, Articles in PubMed by IBRAHIM ABBASS, MS Pharm, RPh, Articles in Google Scholar by IBRAHIM ABBASS, MS Pharm, RPh, Other articles in this journal by IBRAHIM ABBASS, MS Pharm, RPh, Volume 31, Collection 2 - Electronic Health Record Acceptance/Productivity, Privacy Policy (Updated December 15, 2022). Sockolow P.S., Bowles K.H., Lehmann H.P., Abbott P.A., Weiner J.P. Community-Based, Interdisciplinary Geriatric Care Team Satisfaction with an Electronic Health Record A Multimethod Study. N.D. undertook the initial data collection and screened the titles of all potentially relevant studies. Dobrow M.J., Bytautas J.P., Tharmalingam S., Hagens S. Interoperable Electronic Health Records and Health Information Exchanges: Systematic Review. National Library of Medicine 29 January2 February 2018; pp. In the latter case, the patient is given access to the EHR by the care provider without the patient controlling it. Some of the barriers with high occurrence suggested in our results are resource constraints, poor/insufficient training and a lack of technical/educational support for users, as well as poor literacy and a lack of skills in technology. Gaps between EHR design and the functionality needed in the complex inpatient environment resulted in a lack of standardized workflows [89]. Barriers to Electronic Health Record Adoption: A Systematic Literature Review. Barriers and facilitators to using electronic healthcare records in Jordanian hospitals from the nurses perspective: A national survey. Wolters Kluwer Health Many of the initial expectations regarding time efficiency, productivity, and increased quality of care have not been met or have only been partially realized, and current EHRs still do not meet the needs of todays rapidly changing healthcare environment [2]. Almost two-thirds of the respondent hospitals in both years (63.9% in 2007 and 68.4% in 2008) had a high electronic health record index (5). Ochoa A., Kitayama K., Uijtdehaage S., Vermillion M., Eaton M., Carpio F., Serota M., Hochman M.E. Furthermore, in another study documentation was found to be significantly more likely (p < 0.01) to comply with guidelines post-EHR implementation than pre-EHR implementation [50]. Electronic health record systems: risks and benefits - PMC [ . Effect on VA Patient Satisfaction of Providers Use of an Integrated Viewer of Multiple Electronic Health Records. Liew C.L., Harjadinata J. Nurses perceptions of the impact of electronic health records on work and patient outcomes. Nurses reported that patient misuse of PHR for reporting medical emergencies posed potential risks for patient safety [141]. Difficulty in following the new workflow after EHR implementation was raised by clinicians and other staff [46]. Perceived general efficiency gains in workflow [27] and in laboratory turnaround time [29] were found, with these time-consuming tasks related to paper-based records being no longer required [29,41,44]. Perspectives and Uses of the Electronic Health Record Among US Pediatricians A National Survey. The Impact of Electronic Health Records on the Duration of Patients Visits: Time and Motion Study. EHRs in primary care practices: Benefits, challenges, and successful strategies. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The quantity and quality of the contents of nursing documentation were found to be better in paper-based records than in EHRs in a study [122]. The long-term financial impact of electronic health record implementation. Yau G.L., Williams A.S., Brown J.B. Family physicians perspectives on personal health records: Qualitative study. OpenNotes After 7 Years: Patient Experiences with Ongoing Access to Their Clinicians Outpatient Visit Notes. Multiple researchers opinions and consensus meetings were adopted in an attempt to control for this. The impact of electronic health record systems on clinical - PubMed Studies have linked electronic health records (EHRs) with a positive ROI and improved organizational efficiency in nursing. Two-year longitudinal assessment of physicians perceptions after replacement of a longstanding homegrown electronic health record: Does a J-curve of satisfaction really exist? This was supported by studies which showed that a majority of respondents (clinicians) agreed on the benefits of EHRs related to the support of learning and decision-making [49,99]. As the use of electronic health records increases, it becomes necessary to address their global impact on nurses' productivity in hospitals. Before Kariotis T.C., Harris K.M. disagreed. The https:// ensures that you are connecting to the Alami H., Lehoux P., Gagnon M.-P., Fortin J.-P., Fleet R., Ag Ahmed M.A. After all, it is within a specific study context that an author draws conclusions about an investigated system, and it is thus the contextual information that enables readers to interpret the findings. CIN: Computers, Informatics, Nursing30(5):237-241, May 2012. Khan U.R., Zia T.A., Pearce C., Perera K. Perceptions and Experiences of General Practice Users about My Health Record. Instead, the results indicated the existence of serious problems and deficiencies which considerably hindered the efficiency of EHR use [136]. When order sets do not align with clinician workflow: Assessing practice patterns in the electronic health record.
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