Do electronic medical record (EMR) demonstrations change attitudes, knowledge, skills or needs?

INTRODUCTION Electronic medical records (EMRs) are the future of primary care. Transition to electronic records can have a significant impact on physicians, office staff, nursing staff and patients. There are no published EMR studies combining these four populations or studies that have evaluated the impact of EMR demonstrations. To better understand the impact of EMRs, an online survey was administered before and after EMR demonstrations. METHODS A longitudinal cohort survey design was used to assess primary outcomes (attitudes, knowledge, skills and needs) related to EMRs in four populations that were divided into two groups--one of physicians and the other of nursing staff, office staff and patients. A total of 39 participants (19 physicians and 20 staff/patients) completed a pretest survey four weeks prior to and post-test surveys at four and ten weeks after EMR demonstrations. Mean composite scores for each primary outcome were calculated for each group and mean differences were calculated and compared within and between groups--from baseline to four weeks and four to ten weeks using paired t-tests and Student's t-tests, respectively. RESULTS Groups differed in several areas: physicians were younger, had more education and had fewer years of experience in a primary care office. There were no significant differences in gender or computer experience between groups. Staff/patients reported significant improvements in attitudes, knowledge and needs from baseline to four weeks (P<0.05, P<0.01 and P<0.05). Physician attitudes, knowledge and needs significantly increased at week four (P<0.05, P<0.01 and P<0.05). Attitudes, knowledge and needs were sustained in both groups from week four through to week ten. CONCLUSION EMR demonstrations improved attitudes, knowledge and needs of staff/patients and physicians. EMR demonstrations may be effective in favorably influencing healthcare personnel towards EMRs.

[1]  C A Murphy,et al.  Pretest and post-test attitudes of nursing personnel toward a patient care information system. , 1994, Computers in nursing.

[2]  S. Ornstein,et al.  Patient perspectives on computer-based medical records. , 1994, The Journal of family practice.

[3]  S. Ornstein,et al.  Electronic medical records in family practice: the time is now. , 1997, The Journal of family practice.

[4]  C. K. Barsukiewicz,et al.  Electronic medical records: are physicians ready? , 1999, Journal of healthcare management / American College of Healthcare Executives.

[5]  B Stello,et al.  Avoiding common pitfalls in selecting an EMR system. , 1999, Family practice management.

[6]  Julie M. Fiskio,et al.  Evaluating physician satisfaction regarding user interactions with an electronic medical record system , 1999, AMIA.

[7]  Karim Keshavjee,et al.  Measuring the success of electronic medical record implementation using electronic and survey data , 2001, AMIA.

[8]  Cynthia S. Gadd,et al.  Assessing physician attitudes regarding use of an outpatient EMR: a longitudinal, multi-practice study , 2001, AMIA.

[9]  Gregory Makoul,et al.  Research Paper: The Use of Electronic Medical Records: Communication Patterns in Outpatient Encounters , 2001, J. Am. Medical Informatics Assoc..

[10]  J. Aaronson,et al.  Electronic medical records: the family practice resident perspective. , 2001, Family medicine.

[11]  G. A. Loomis,et al.  If electronic medical records are so great, why aren't family physicians using them? , 2002, The Journal of family practice.

[12]  Charles J Zelnick,et al.  A medical informatics curriculum for 21st century family practice residencies. , 2002, Family medicine.

[13]  Gregory M Garrison,et al.  21st-century health care: the effect of computer use by physicians on patient satisfaction at a family medicine clinic. , 2002, Family medicine.

[14]  Thomas K. Houston,et al.  Patient Perceptions of Physician Use of Handheld Computers , 2003, AMIA.

[15]  Kenneth L Evans,et al.  The Future of Family Medicine: A Collaborative Project of the Family Medicine Community , 2004, The Annals of Family Medicine.

[16]  Arild Faxvaag,et al.  Task-oriented evaluation of electronic medical records systems: development and validation of a questionnaire for physicians , 2004, BMC Medical Informatics Decis. Mak..

[17]  Blackford Middleton,et al.  Viewpoint Paper: Accelerating U.S. EHR Adoption: How to Get There From Here. Recommendations Based on the 2004 ACMI Retreat , 2005, J. Am. Medical Informatics Assoc..

[18]  Daniel B. Hier,et al.  Differing faculty and housestaff acceptance of an electronic health record , 2005, Int. J. Medical Informatics.

[19]  John Hsu,et al.  Effects of exam-room computing on clinician-patient communication , 2005, Journal of General Internal Medicine.

[20]  John G. Scott,et al.  Implementing an Electronic Medical Record in a Family Medicine Practice: Communication, Decision Making, and Conflict , 2005, The Annals of Family Medicine.

[21]  Nir Menachemi,et al.  Reviewing the Benefits and Costs of Electronic Health Records and Associated Patient Safety Technologies , 2006, Journal of Medical Systems.

[22]  Sharon McLane Designing an EMR Planning Process Based on Staff Attitudes Toward and Opinions About Computers in Healthcare , 2005, Computers, informatics, nursing : CIN.

[23]  J. Dove The electronic health record--the time is now. , 2005, The American heart hospital journal.

[24]  Robert L Edsall,et al.  An EHR user-satisfaction survey: advice from 408 family physicians. , 2005, Family practice management.

[25]  Kathy Smith,et al.  Evaluating the Impact of Computerized Clinical Documentation , 2005, Computers, informatics, nursing : CIN.

[26]  A. Westin,et al.  Public attitudes toward electronic health records. , 2005, AHIP Coverage.

[27]  Thomas W Dillon,et al.  Nursing Attitudes and Images of Electronic Patient Record Systems , 2005, Computers, informatics, nursing : CIN.

[28]  David W. Bates,et al.  Primary care physician time utilization before and after implementation of an electronic health record: A time-motion study , 2005, J. Biomed. Informatics.

[29]  Nir Menachemi,et al.  Barriers to ambulatory EHR: who are 'imminent adopters' and how do they differ from other physicians? , 2006, Informatics in primary care.

[30]  K. Dontje,et al.  Electronic health record: implementation across the Michigan Academic Consortium. , 2006, Computers, informatics, nursing : CIN.

[31]  Hien H. Nguyen,et al.  Electronic Medical Records and Their Impact on Resident and Medical Student Education , 2006 .

[32]  Tae-Sa Ahn,et al.  Nurses' perceptions of and attitudes toward an electronic medical record system at Seoul National University Hospital. , 2006, Studies in health technology and informatics.

[33]  Peggy Nygren,et al.  Physicians, Patients, and the Electronic Health Record: An Ethnographic Analysis , 2006, The Annals of Family Medicine.