Cauldwell M et al. 2007 "The impact of electronic patient records on workflow in general practice."
Reference
Cauldwell M, Beattie C, Cox B, et al. The impact of electronic patient records on workflow in general practice. Health Informatics J 2007;13(2):155-160.
Abstract
"[A patient access system] allows patients to register their arrival at a GP's [general practitioner's] surgery and to view their healthcare record electronically whilst in the waiting area. The research reported in this short article was carried out to identify potential changes in clinical and administrative workflow resulting from the introduction of the system. The study considers workflow pre and post the implementation of [the system]. It also makes comparisons between two UK London-based surgeries, one with [the system] (Wells Park Practice) and one without such a system (South Lewisham Group Practice). The impact of [the system] on workflow and the potential benefits for GPs, administrative staff and patients are highlighted."
Objective
To identify potential changes in clinical and administrative workflow resulting from the introduction of a system giving patients access to view their provider's electronic health record application.
Tools Used
Type Clinic
Primary care
Type Specific
Family practice
Size
Small and/or medium
Other Information
Ten physicians were located at each practice.
Type of Health IT
Patient access system
Type of Health IT Functions
The system allows patients to register their arrival at a GP's surgery by fingerprint recognition and to view their healthcare record electronically while in the waiting area, including previous consultations, results and referral letters.
Context or other IT in place
Electronic health records (EHR)
Workflow-Related Findings
"The GPs at [the intervention site] estimated that ... [patients viewing their electronic records] had resulted in a reduction in the proportion of time spent during consultation explaining results/reports. Prior to the introduction of [the system] this proportion was estimated at 22.3 per cent of the total consultation time, compared with 19.3 per cent post implementation."
"The GPs at [the intervention site] reported a fall in the proportion of time spent correcting inaccuracies in notes ... [and] a fall in the proportion of time spent explaining written notes to patients."
"[T]he administrative staff at [the intervention site] reported that the ... system had reduced the amount of time registering patients and 75% of them perceived a reduction in the overall time spent dealing with appointments.... [The benefits of this] are somewhat ameliorated by the need to spend time demonstrating to patients how to use the system."
Three patients at the control site had to wait over 1 minute to register. One patient using the ... system had to wait over 1 minute because he had to wait to use the system.
The average length of consultation time at the control site was 11.9 minutes, while the average length for patients who had used the ... system was 10.11 minutes. Of those who had used the ... system, 77.8 percent indicated that they believed viewing their electronic record before the consultation had reduced its length.
Fourteen out of 15 patients using the system "express[ed] the view that it had made the consultation more efficient."
Study Design
Only postintervention with intervention and control groups
Study Participants
The study involved 47 patients, four GPs and three staff at the control clinic; and 53 patients, five GPs and eight staff at the implementing clinic.