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Investigating changes in end-user satisfaction with installation of an electronic medical record in ambulatory care settings

Authors

Gamm LD, Barsukiewicz CK, Dansky KH, Vasey JJ

Journal

J Healthc Inf Manag

Publication Date

1998 Winter

Volume

Issue

Pages

53-65

HIT Description: Electronic medical record (EMR). More info...
Purpose of Study: Examine perceptions, attitudes and behaviors among physicians, nurses, and non-clinical staff regarding the installation of an electronic medical record.
Years of study: 1997-1998
Study Design: Pre-Post
Outcomes: Other outcome

Summary:

Settings: The study was conducted at six ambulatory care sites.
Intervention: Installation of an electronic medical record.
Evaluation Method: Measures of user satisfaction using a survey design, on-site observation, and qualitative interviews.
Description: The electronic medical record was installed in 1996 in three sites and in 1997 in the other three sites.
Strategy: Two sites had a full-immersion approach, one site had a user and function incremental approach, and the approach for the other sites is not described.
Barriers: The authors concluded that allowing great variability in physicians use of the EMR to increase acceptance, will instead lead to resistance, and they suggest for the EMR adoption to enforce new process, instead of automating existing processes.
Quality of Care and Patient Safety Outcome: For physicians, post-installation perceptions of EMR's contributions to the improvement of patient quality of care showed a statistically significant decrease from their high pre-installation expectations six months after installation. For both physicians and nurses, ratings decrease from pre- to post-installation for EMR's helpfulness in reducing the number of medical record errors.
Changes in efficiency and productivity: Regarding overall ratings of time savings, physicians and nurses showed statistically significant decreases from pre-installation to post-installation expectations. For staff, there was only statistically significant decrease for Òtime scheduling consultsÓ. Work productivity assessment showed statistically significant decreases among physicians on several EMR items, and among nurses on Òsystem contributes to my productivityÓ, but none for staff. Also, physicians and nurses assessment of management support declined significantly for many items, and for staff only in one item. The correlation analysis showed that physician satisfaction with EMR improves after a year's use of the system.�

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