EHR implementation in a new clinic: a case study of clinician perceptions

Area of Science:

• Health Informatics
• Clinical Systems Implementation
• Healthcare Management

Background:

• The Health Information Technology for Economic and Clinical Health (HITECH) Act mandates widespread adoption of electronic health records (EHR).
• Existing studies on EHR transitions show mixed provider satisfaction, potentially influenced by the change process itself.
• A need exists to evaluate EHR efficacy independent of paper-to-electronic conversion reactions.

Purpose of the Study:

• To assess the true efficacy of electronic health records (EHR) by surveying providers in a new health center, minimizing bias from prior conversion experiences.
• To identify key themes related to EHR impact on workflow, communication, patient care, and productivity.
• To provide actionable insights for optimizing EHR implementation and mitigating unintended consequences.

Main Methods:

• Conducted semi-structured interviews with healthcare providers at a new health center to gather qualitative data.
• Focused inquiry on critical areas: workflow, communication, patient satisfaction, productivity, documentation, and quality of care.
• Employed thematic analysis to identify recurring positive and negative experiences with EHR systems.

Main Results:

• Ten major themes emerged, including impeded patient flow, communication challenges (in-office) and improvements (post-visit), enhanced patient care tracking, reduced patient face-time, and increased training needs.
• Providers desired more EHR features and experienced diminished productivity, yet appreciated template benefits and enhanced internal communication.
• The necessity for comprehensive EHR training was a significant factor influencing multiple identified themes.

Conclusions:

• Findings validate concerns from previous EHR transition studies, suggesting inherent challenges beyond the conversion process.
• The study's methodology offers a valuable framework for early identification of critical themes in new EHR implementations.
• Proactive recognition of EHR-related themes can help maximize benefits and prevent negative outcomes, ensuring successful system integration.