Replacing an inpatient electronic medical record. Lessons learned from user satisfaction with the former system

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Healthcare Management

Background:

• Successful implementation of electronic clinical information systems (ECIS) is critical for modern healthcare.
• Understanding user attitudes towards existing systems is essential for effective transition strategies.
• Previous systems often comprise both paper-based and electronic components, leading to complex user perceptions.

Purpose of the Study:

• To explore the variation in user attitudes towards the system being replaced.
• To determine the extent of these variations among different user groups and system components.
• To inform strategies for the successful adoption of new electronic record systems.

Main Methods:

• A cross-sectional survey was conducted with 346 nurses and physicians in two Canadian teaching hospitals.
• User attitudes were assessed based on satisfaction with quality attributes, perceived usefulness, and perceived impact on care quality and patient safety.
• The existing system was analyzed as a dual entity: paper-based and electronic records.

Main Results:

• Significant variation in user satisfaction was observed (4.2-7.7 on a 10-point scale).
• Electronic record components generally received higher satisfaction scores than paper-based records.
• Nurses showed a preference for paper-based records, while physicians rated formats differently; strong interdependencies were found among attitude dimensions.

Conclusions:

• User attitudes toward both paper and electronic aspects of current clinical information systems are crucial for successful electronic record system implementation.
• Tailoring implementation strategies based on understanding diverse user perspectives and system components is vital.
• Addressing user satisfaction with quality attributes, usefulness, and impact on care is essential for ECIS adoption.