A study of general practitioners’ perspectives on electronic medical records systems in NHSScotland

Abstract

BackgroundPrimary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012.MethodsWe carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs’ perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees’ responses, using Normalisation Process Theory as the underpinning conceptual framework.ResultsThe majority of GPs’ interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities – for example: in relation to usability, system navigation and information visualisation.ConclusionOur study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs’ interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors.

Health care consumer’s perception of the Electronic Medical Record (EMR) system within a referral hospital in Kigali, Rwanda

“…In the current study, participants who were aged 40 years and less, 20(15.3%)preferred a paper based medical record compared to those who were above 40 (28.2%) preferred paper based. documents" (P4).The current study of the implementation of an EMR was also supported by (Bouamrane & Mair, 2013)). This study reported that general practitioners' perspectives on electronic medical records systems in NHS Scotland felt their EMR system improved the record keeping This current research study of the OpenClinc EMR has not only improved the efficiency but also the quality of health care delivery with in Rwanda.…”

Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective

“…However, Bru-HIMS end-users were given training in functions that were not needed in the dental department, and they struggled to get appropriate technical training and support from the vendor -a problem that appears to be frequent with HIS implementation despite its impact in potentially improving the experience of clinicians [92,46,93].…”

LAB-IN-A-BOX: semi-automatic tracking of activity in the medical office

“…A recent review [34] of 9 years of EHR studies found the majority of EHRs have had very limited to negative impact on clinical workflow, and documenting improvements is difficult. Other recent reviews of studies, such as [29] which analyzed 12 years of EHR data, or [5] which looked at semi-structured interviews with physicians, concluded that there is not yet evidence of a clear impact of EHRs on clinical outcomes. Although interesting and clearly showing that there is work to do, the reports are too vague to point to where the problems may lie.…”

“…SMI RED-m eye tracker. 5 The RED-m is a remote eye tracker, that along with an Epiphan DVI-2-USB3.0 frame grabber, provides us with screen capture and corresponding tracking metrics to indicate where our participants were looking on their computer screen while interacting with the EHR. Standard eye trackers (including the SMI RED-m) provide solutions to track gaze directed to the screen of a dedicated portable computer.…”

“…The US government, for example, is investing $19.2 billion to encourage widespread EHR adoption by the end of 2014 [47], and outside the USA, many have already embarked on large implementations of EHR systems over the last few years [5,35]. If EHRs are well designed and effectively used, they have the potential to improve patient health outcomes, patient safety, clinical efficiency, and patient-centered aspects of care [10,26,49].…”