Approaches and challenges to optimising primary care teams' electronic health record usage

Abstract

Background Although the presence of an electronic health record (EHR) alone does not ensure high quality, efficient care, few studies have focused on the work of those charged with optimizing use of existing EHR functionality. Objective To examine the approaches used and challenges perceived by analysts supporting the optimization of primary care teams’ EHR use at a large U.S. academic healthcare system. Methods A qualitative study was conducted. Optimization analysts and their supervisor were interviewed and data was analyzed for themes. Results Analysts needed to reconcile the tension created by organizational mandates focused on the standardization of EHR processes with the primary care teams’ demand for EHR customization. They gained an understanding of health information technology (HIT) leadership’s and primary care team’s goals through attending meetings, reading meeting minutes, and visiting with clinical teams. Within what was organizationally possible, EHR education could then be tailored to fit team needs. Major challenges were related to organizational attempts to standardize EHR use despite varied clinic contexts, personnel readiness, and technical issues with the EHR platform. Forcing standardization upon clinical needs that current EHR functionality could not satisfy was difficult. Conclusions Dedicated optimization analysts can add value to health systems through playing a mediating role between HIT leadership and care teams. Our findings imply that EHR optimization should be performed with an in-depth understanding of the workflow, cognitive, and interactional activities in primary care.

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“…Special attention was paid to the European research papers and studies in the field of information technology (IT) adoption,21 quality evaluation22 – 27 and usability28 – 30 of the ambulatory EHR systems. Trying to assess the situation and the specifics of Croatian health system, we analysed the significant results of research on the health information system in the Republic of Croatia 3 , 4 , 31 – 37.…”

In this issue - Making sense of taxonomies in health informatics

“…The key in achieving this was the development of a mediating managerial layer between managers and clinical teams. 12 This approach resulted in the tailoring of programmes to fit teams; and perhaps pruning the branches of the informatics tree of life, rather than let them overextend and fall. This paper has a clear location on the biaxial taxonomy (Figure 4).…”

“…Maybe this provides insight into what are the prevailing themes that might make up a taxonomy for health informatics. Morrison et al 10 Morrison et al 10 Levy et al 9 Levy et al 9 Pandhi et al 12 Prazeres 13 Prazeres 13 Levy et al 9 Bush et al 11 Morrison et al 10 Morrison et al 10 Pandhi et al 12 Pietrzak et al 8 Bush et al 11 Pandhi et al 12 Pietrzak et al …”