Implementing computers in ambulatory care: implications of physician practice patterns for system design

Area of Science:

• Health Informatics
• Medical Practice Management
• Human-Computer Interaction

Background:

• Electronic Medical Records (EMR) adoption is increasing in healthcare.
• Pre-implementation insights are crucial for successful EMR rollout.
• Physician perspectives significantly influence technology adoption.

Purpose of the Study:

• To gather pre-implementation data on physician attitudes and concerns regarding EMR adoption.
• To identify key factors influencing the successful integration of EMR systems in a large physician group practice.
• To inform strategies for optimizing EMR implementation and physician training.

Main Methods:

• Short-term participant observation within an internal medicine division.
• Semi-structured interviews with physicians prior to EMR implementation.
• Qualitative data analysis to identify key themes and concerns.

Main Results:

• Most physicians anticipate benefits and are willing to use the EMR system.
• Key usability concerns include computer accessibility, login ease, and support for interrupted workflows.
• Physicians expressed concerns about maintaining patient eye contact and the feasibility of self-documentation for lengthy notes.
• A staged implementation approach, starting with order entry, is suggested for gradual adaptation.
• Comprehensive training should include protected instructional time, simulated practice, and in-clinic support.

Conclusions:

• Physician willingness to adopt EMR is high, contingent on system usability and workflow integration.
• Addressing concerns about patient interaction and documentation burden is critical for successful EMR implementation.
• A phased rollout and robust, tailored training program are essential for optimizing physician adaptation and EMR utilization.