Adoption and Efficiency of an Anesthesia Information Management System: Evaluation of Workflow Integration in...

Background: Anesthesia Information Management Systems (AIMSs) support perioperative documentation and clinical decision-making, but their real-world adoption remains heterogeneous and incompletely understood. Methods: This study combined a cross-sectional survey with a randomized crossover simulation study conducted at a tertiary care center following AIMS implementation. All anesthesiologists were invited to complete a structured questionnaire assessing satisfaction, usability, adoption, and use of decision-support functionalities. In the simulation study, participants entered standardized intraoperative data into both paper-based records and the electronic AIMS, with documentation time recorded. Survey data were analyzed descriptively with subgroup analyses, and documentation times were compared using the Wilcoxon signed-rank test. Results: A total of 27 anesthesiologists participated. Overall satisfaction and workflow integration were high, with 81.48% reporting that the system was easy to use and well-integrated into clinical practice. Electronic documentation was preferred across multiple domains, including time efficiency (92.59%) and accuracy (85.19%). In the simulation study, electronic documentation was significantly faster than paper-based documentation (median 540 vs. 1140 s; p = 0.0016). Adoption patterns demonstrated a bimodal distribution, with no association with technological literacy or engagement with educational materials. Decision-support features embedded within routine workflows were used more frequently than those requiring additional navigation. Conclusions: AIMS implementation was associated with high user satisfaction and improved documentation efficiency, but showed heterogeneous adoption and selective feature use. Effective integration appears to depend on workflow alignment rather than user characteristics alone.