Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers

BMC Medical Informatics and Decision Making

Research Article

Manjula Cherukuri¹  Lipika Samal²  Temple Howell-Stampley³  Ethan A Halm³  Brett Moran³  Lynne Kirk³  Kim Batchelor³  Anil N Makam³  Noel Santini⁴  Holly J Lanham⁵  Luci K Leykum⁵ 

[1] Department of Family and Community Medicine, University of North Texas Health Science Center, 1650 S. Beach St, 76105, Fort Worth, TX, USA;Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, 1620 Tremont St., OBC-3, 02120, Boston, MA, USA;Division of General Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390, Dallas, TX, USA;Division of General Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390, Dallas, TX, USA;Community Medicine Division, Parkland Health & Hospital System, 5201 Harry Hines Blvd, 75235, Dallas, TX, USA;Division of Hospital Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr. MC7982, 78229, San Antonio, TX, USA;South Texas Veterans Health Care System, 7400 Merton Minter, 78229, San Antonio, TX, USA;

关键词: Electronic health record (EHR);    Attitude of health personnel;    Attitude to computers;    Primary care;    Efficiency;    Quality of care;    Medical informatics/utilization;   

DOI  :  10.1186/1472-6947-13-86

 received in 2013-01-30, accepted in 2013-08-02,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundDespite considerable financial incentives for adoption, there is little evidence available about providers’ use and satisfaction with key functions of electronic health records (EHRs) that meet “meaningful use” criteria.MethodsWe surveyed primary care providers (PCPs) in 11 general internal medicine and family medicine practices affiliated with 3 health systems in Texas about their use and satisfaction with performing common tasks (documentation, medication prescribing, preventive services, problem list) in the Epic EHR, a common commercial system. Most practices had greater than 5 years of experience with the Epic EHR. We used multivariate logistic regression to model predictors of being a structured documenter, defined as using electronic templates or prepopulated dot phrases to document at least two of the three note sections (history, physical, assessment and plan).Results146 PCPs responded (70%). The majority used free text to document the history (51%) and assessment and plan (54%) and electronic templates to document the physical exam (57%). Half of PCPs were structured documenters (55%) with family medicine specialty (adjusted OR 3.3, 95% CI, 1.4-7.8) and years since graduation (nonlinear relationship with youngest and oldest having lowest probabilities) being significant predictors. Nearly half (43%) reported spending at least one extra hour beyond each scheduled half-day clinic completing EHR documentation. Three-quarters were satisfied with documenting completion of pneumococcal vaccinations and half were satisfied with documenting cancer screening (57% for breast, 45% for colorectal, and 46% for cervical). Fewer were satisfied with reminders for overdue pneumococcal vaccination (48%) and cancer screening (38% for breast, 37% for colorectal, and 31% for cervical). While most believed the problem list was helpful (70%) and kept an up-to-date list for their patients (68%), half thought they were unreliable and inaccurate (51%).ConclusionsDissatisfaction with and suboptimal use of key functions of the EHR may mitigate the potential for EHR use to improve preventive health and chronic disease management. Future work should optimize use of key functions and improve providers’ time efficiency.

【 授权许可】

CC BY   
© Makam et al.; licensee BioMed Central Ltd. 2013