Collect Once, Use Many Times: End-Users Don't Practice What They Preach

Data in an Electronic Health Record must be recorded once, in a standardized and structured way at the point of care to be reusable within the care process as well as for secondary purposes ('collect once, use many times' (COUMT) paradigm). COUMT has not yet been fully adopted by staff in every organization. Our study intends to identify concepts that underlie its adoption and describe its current status in Dutch academic hospitals. Based on literature we have constructed a model that describes these concepts and that guided the development of a questionnaire investigating COUMT adoption. The questionnaire was sent to staff working with patient data or records in seven out of eight Dutch university hospitals. Results show high willingness of end-users to comply to COUMT in the care process. End-users agree that COUMT is important, and that they want to work in a structured and standardized way. However, end-users indicate to not actually use terminology or information standards, but often register diagnoses and procedures in free text, and experience repeated recording of data. In conclusion, we found that COUMT is currently well adopted in mind, but not yet in practice.