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Enhancing Standardized and Structured Recording by Elderly Care Physicians for Reusing Electronic Health Record Data:

Charlotte A W Albers1,2,3, Yvonne Wieland-Jorna4, Martine C de Bruijne5,6

  • 1Department of Medicine for Older People, Location Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.

JMIR Medical Informatics
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Summary
This summary is machine-generated.

Elderly care physicians use electronic health records for patient care and accountability. Standardized recording in EHRs can be improved by aligning with primary care processes and addressing personal, organizational, and system-level factors.

Keywords:
attitude of health personneldigital healthelectronic health recordshealth information exchangehealth information interoperabilitylong-term caremedical recordsnursing homesqualitative researchreference standards

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Area of Science:

  • Health Informatics
  • Geriatric Medicine
  • Health Services Research

Background:

  • Nursing home electronic health records (EHRs) lack structured data, hindering information exchange and reuse.
  • Standardized and structured recording in EHRs is crucial for improving care quality and research in elderly care.

Purpose of the Study:

  • To understand why and how elderly care physicians (ECPs) record data in EHRs.
  • To identify factors influencing ECPs' adoption of standardized and structured recording.
  • To inform recommendations for enhancing EHR data reuse.

Main Methods:

  • Semistructured interviews with 13 ECPs in Dutch nursing homes.
  • Purposive sampling to ensure participant diversity.
  • Inductive thematic analysis of interview data.

Main Results:

  • ECPs use EHRs for daily patient care, continuity, and accountability.
  • Secondary uses include quality improvement and research.
  • Factors influencing standardized recording include perceived value, organizational guidelines, EHR usability, and national standards.

Conclusions:

  • Findings align with previous research in hospital and general practice settings.
  • Standardized recording in long-term care can benefit from solutions in other sectors.
  • Improving standardized recording requires aligning EHRs with primary care and addressing multi-level incentives.