Patient experience in an EMR-enabled outpatient clinic: a cross-sectional convergent mixed-methods study

Electronic medical records (EMRs) are widely implemented across health settings and function as sociotechnical systems that shape clinical workflows, information use, and patient-clinician interaction. While EMR impacts on clinician experience have been extensively studied, patient experience of EMR-enabled care remains underexplored. This study aims to examine patient experience in an EMR-enabled outpatient clinic and identify actionable recommendations to optimise clinic outcomes.

A cross-sectional, convergent mixed-methods survey was conducted in a fully digital public diabetes outpatient clinic in Queensland, Australia. Quantitative data, collected using the Patient Experience Monitor (PEM) Adult Outpatient short-form aligned with Picker principles, assessed patient experience across multiple outpatient care domains. Qualitative data, collected through two open-ended items, explored how patients experienced care in the context of clinician-mediated EMR use during consultations and identified opportunities for improvement. Data were collected concurrently and analysed separately. Integration occurred at the reporting stage, where qualitative findings were used to explain and contextualise the quantitative results and to inform practical recommendations.

One hundred patients participated. Quantitative findings showed highly favourable but ceiling-affected patient experience ratings across PEM domains. Qualitative analysis identified four themes: perceived facilitation of informational continuity and coordination of care; perceived reduction in personal interaction; limited patient and GP access beyond the public hospital EMR environment; and background trust and neutral perceptions of EMR use. Integration of findings informed a set of actionable recommendations to optimise EMR-supported workflows, preserve interpersonal engagement, strengthen information continuity across care settings, and enable more participatory models of outpatient care.

Patients perceived aspects of EMR-enabled outpatient care as supporting patient-centred care, particularly when clinicians used integrated information effectively during consultations. Findings highlight the importance of implementing EMRs as sociotechnical systems that not only align with consultation workflows but also preserve interpersonal connection and support participatory care. Achieving this requires meaningful information access and sharing across patients, clinicians, and care settings, providing practical guidance for designing digitally enabled outpatient services.