Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

Tsai, Chen Hsi; Eghdam, Aboozar; Davoody, Nadia; Wright, Graham; Flowerday, Stephen; Koch, Sabine

doi:10.3390/life10120327

Cited by 115 publications

(106 citation statements)

References 144 publications

(452 reference statements)

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“…39 Most physicians in our study indicated that technical support is usually available and that this support is effective. While technical support has been previously identified as a barrier to EHR adoption and use, 40 this did not appear to be a key concern in our sample. Clinical support is less readily available, with a minority of physicians responding that they "always" or "often" received assistance with EHR inbox tasks, while many physician respondents found additional staff support with EHR tasks and documentation to be a useful practice-level strategy.…”

Section: Discussionmentioning

confidence: 61%

Which Strategies Improve Physicians' Experience with Health Information Technology?

et al. 2021

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Objectives While electronic health records (EHRs) have improved billing efficiency and note legibility, they may also disrupt clinical workflows, affect patient interactions, and contribute to physician burnout. This study aimed to identify effective strategies, as reported by physicians, to mitigate these EHR shortcomings. Methods The Rhode Island Department of Health administers a health information technology (HIT) survey biennially to all physicians in active practice statewide. The 2019 survey asked physicians about strategies implemented personally or by their practice to improve their experience working with HIT. Physicians who identified at least one strategy were then asked if each implemented strategy was “actually useful.” Results The 2019 survey was administered to 4,266 physicians, with a response rate of 43%. Both office- and hospital-based physicians most commonly reported that their practices had implemented voice-recognition dictation software (48 and 68%, respectively). Office- and hospital-based physicians identified self-care as the most commonly implemented personal change (48 and 47%, respectively). However, 26% of office-based and 15% of hospital-based physicians reported reducing clinical hours or working part-time to improve their experience working with HIT. The strategies identified as “actually useful” varied by practice setting and were not always the most widely implemented approaches. Conclusion Most physicians reported that both they personally and their practices had implemented strategies to improve their experience with HIT. Physicians found some of these strategies more helpful than others, and the strategies identified as most useful differed between office- and hospital-based physicians. From a workforce and access perspective, prioritizing strategies that physicians find “actually useful” is critical, as many physicians in both settings reported reducing clinical hours to improve their experience.

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Section: Discussionmentioning

confidence: 61%

Which Strategies Improve Physicians' Experience with Health Information Technology?

et al. 2021

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“…To provide an overview of available knowledge on the implementation and use of electronic health record (EHR) systems, including tethered personal health records (PHRs), the article by Tsai et al [ 3 ] presents the current knowledge on the effects of EHR implementation and the barriers to EHR adoption and use. The authors identified positive as well as negative effects on the clinical work, data and information, patient care and economic impact.…”

Section: Presentation Of the Papersmentioning

confidence: 99%

Advances in E-Health

Vimarlund

Koch

Nøhr

2021

Life

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“…[9][10][11] Patient engagement has received considerable attention in recent years, 10 and patient portals may contribute to engaging the patients actively in their care by granting them access to their health data and providing additional functionalities. 7,[12][13][14] To date, we find a very heterogeneous landscape and a broad diversity of patient portals 15 regarding their intended deployment and functionalities. 8,16 Patient portals can be projected for specific care sectors, for example, primary or secondary care based on each care sector's different needs.…”

Section: Introductionmentioning

confidence: 99%

“…A PHR or personal health record provides patients with web-based access to their health data that is under the control of the patient, 1 while an EHR typically is under the control of the provider. 5,9,14 Scheplitz et al 20 created a framework for patient portal functionalities to record all possible functions to identify specification gaps related to software development. Walker et al developed a framework to evaluate how well health information technology can support patient engagement by applying five engagement scoring levels.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Useful Taxonomy of Patient Portals Based on Characteristics of Patient Engagement

Glöggler

Ammenwerth

2021

Methods Inf Med

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Objective Taxonomies are classification systems used to reduce complexity and better understand a domain. The present research aims to develop a useful taxonomy for health information managers to classify and compare patient portals based on characteristics appropriate to promote patient engagement. As a result, the taxonomy should contribute to understanding the differences and similarities of the portals. Further, the taxonomy shall support health information managers to more easily define which general type and functionalities of patient portals they need and to select the most suitable solution offered on the market. Methods We followed the formal taxonomy-building method proposed by Nickerson et al. Based on a literature review, we created a preliminary taxonomy following the conceptional approach of the model. We then evaluated each taxa's appropriateness by analyzing and classifying 17 patient portals offered by software vendors and 11 patient portals offered by health care providers. After each iteration, we examined the achievement of the determined objective and subjective ending conditions. Results After two conceptional approaches to create our taxonomy, and two empirical approaches to evaluate it, the final taxonomy consists of 20 dimensions and 49 characteristics. To make the taxonomy easy to comprehend, we assigned to the dimensions seven aspects related to patient engagement. These aspects are (1) portal design, (2) management, (3) communication, (4) instruction, (5) self-management, (6) self-determination, and (7) data management. The taxonomy is considered finished and useful after all ending conditions that defined beforehand have been fulfilled. We demonstrated that the taxonomy serves to understand the differences and similarities by comparing patient portals. We call our taxonomy “Taxonomy of Patient Portals based on Characteristics of Patient Engagement (TOPCOP).” Conclusion We developed the first useful taxonomy for health information managers to classify and compare patient portals. The taxonomy is based on characteristics promoting patient engagement. With 20 dimensions and 49 characteristics, our taxonomy is particularly suitable to discriminate among patient portals and can easily be applied to compare portals. The TOPCOP taxonomy enables health information managers to better understand the differences and similarities of patient portals. Further, the taxonomy may help them to define the type and general functionalities needed. But it also supports them in searching and comparing patient portals offered on the market to select the most suitable solution.

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Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

Cited by 115 publications

References 144 publications

Which Strategies Improve Physicians' Experience with Health Information Technology?

Which Strategies Improve Physicians' Experience with Health Information Technology?

Advances in E-Health

Development and Validation of a Useful Taxonomy of Patient Portals Based on Characteristics of Patient Engagement

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