A new instrument for measuring clinician satisfaction with electronic health records

A new survey instrument was developed and validated to measure clinician (nurse) satisfaction with electronic health record impact on clinical process. The Health Information Technology Reference-Based Evaluation Framework guided the selection of evaluation dimensions for the survey. Survey questions were gathered from existing health information technology satisfaction surveys that reflected individual evaluation concepts, such as efficiency or benefits. Decisions about data-gathering methods (e.g., item selection) were made based on reviews of literature and surveys of clinician satisfaction with health information technology and expert input. Preliminary instrument validation was accomplished using qualitative and statistical analysis of five repeated sets of responses from clinicians at the pilot site and field administrations repeated twice at electronic health record implementation and paper-based comparison sites and by analyzing convergent evidence from observations and interviews. Reliability was assessed on one sample: 30 graduate nursing students at the single pilot site. Validity was assessed on three separate samples: (1) graduate nursing students (n = 30), (2) field test at a site with electronic health record (n = 39 participants), and (3) field test at a paper-based site (n = 17). The implementation and comparison sites are Program of All-Inclusive Care for the Elderly that provide managed day care for frail elderly. Survey responses were assessed for test-retest reliability, internal consistency, and content and construct validity. The instrument design enables its administration before and after electronic health record implementation. Work to date suggests the instrument is reliable and valid; it is offered to electronic health record evaluators for further testing and application.