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J Am Med Inform Assoc. 2018 Jun 1;25(6):618-626. doi: 10.1093/jamia/ocx094.

Implementing electronic health records (EHRs): health care provider perceptions before and after transition from a local basic EHR to a commercial comprehensive EHR.

Author information

1
Center for Applied Health Services Research, Ochsner Clinic Foundation, New Orleans, LA, USA.
2
Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
3
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
4
Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
5
Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, USA.
6
Department of Health Sciences, Furman University, Greenville, SC, USA.
7
Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
8
The University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, McGovern Medical School at The University of Texas Health Sciences Center at Houston, TX, USA.
9
University of Texas School of Biomedical Informatics at Houston, Houston, TX, USA.
10
Cardiology Section, Department of Medicine, Ochsner Health System, New Orleans, LA, USA.

Abstract

Objective:

We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR.

Methods:

Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health care providers before (baseline) and at 6-12 months (short term) and 12-24 months (long term) after the transition. We analyzed 32 items for the overall group and by practice setting, provider age, and specialty using separate multivariable-adjusted random effects logistic regression models.

Results:

A total of 223 providers completed all 3 surveys (30% response rate): 85.6% had outpatient practices, 56.5% were >45 years old, and 23.8% were primary care providers. The percentage of providers with positive perceptions significantly increased from baseline to long-term follow-up for patient communication, hospital transitions - access to clinical information, preventive care delivery, preventive care prompt, preventive lab prompt, satisfaction with system reliability, and sharing medical information (Pā€‰<ā€‰.05 for each). The percentage of providers with positive perceptions significantly decreased over time for overall satisfaction, productivity, better patient care, clinical decision quality, easy access to patient information, monitoring patients, more time for patients, coordination of care, computer access, adequate resources, and satisfaction with ease of use (Pā€‰<ā€‰0.05 for each). Results varied by subgroup.

Conclusion:

After a transition to a commercial comprehensive EHR, items with significant increases and significant decreases in the percentage of providers with positive perceptions of EHR benefit were identified, overall and by subgroup.

PMID:
29036503
DOI:
10.1093/jamia/ocx094

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