End-user support for primary care electronic medical records: a qualitative case study of users’ needs, expectations, and realities

Shachak, Aviv; Montgomery, Catherine; Dow, Rustam; Barnsley, Jan; Tu, Karen; Jadad, Alejandro R.; Lemieux‐Charles, Louise

doi:10.1057/hs.2013.6

Cited by 17 publications

(7 citation statements)

References 43 publications

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“…Without strong support to help clinicians and other system users to effectively adapt a new EHR, distrust, frustration, and slow adoption can result. 4 In an article by Boonstra and Broekhus, physicians perceived a need for proper support and were reluctant to use the EHR without it. 5 Simon et al, found that two-thirds of physicians indicated a lack of support as a barrier to them adopting EHRs.…”

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confidence: 99%

“…7 A common theme in the literature emphasizes the need for providing on-site support during implementation and is seen as a critical factor to effective adoption. 4,5,[7][8][9][10][11][12] Using the model for improvement, endorsed by the Institute for Healthcare Improvement as a framework, this case report will describe the activities that follow the planning, doing, studying, and acting of providing on-site support to clinicians and other system end-users at Vanderbilt University Medical Center (VUMC) during a recent EHR implementation. Activities and processes deemed as effective during the first 3 weeks of implementation will be shared along with challenges and lessons learned.…”

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confidence: 99%

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An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

Kiepek

Sengstack

2019

Appl Clin Inform

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Background Electronic health record (EHR) system implementation is complex. Strong support for clinicians and other end-users during the initial phase of implementation requires dedicated resources and commitment to ensure a smooth transition, reduce frustration, and assist in adoption. Objectives Evaluate end-user support processes and personnel employed during the initial phase of EHR implementation at an academic medical center and identify facilitators of success, challenges, and lessons learned. Methods Using the model for improvement framework, this case report describes the activities that follow the concepts of planning, doing, studying, and acting (PDSA) when providing on-site support to system end users during an EHR implementation in a complex health care system. Results Strengths included engaged and supportive leadership, use of internal support personnel, use of zone leaders, daily huddles for effective dissemination of information, and an evaluation survey tool to provide data supporting rapid changes in support personnel allocation. Challenges primarily surrounded the management of over 1,000 external support personnel which included limited EHR system knowledge, scheduling, and transportation logistics. Conclusion Implementation of EHR systems continues. Supporting end users is one aspect of these complex projects that require dedicated resources to manage effectively. Organizations taking a more proactive approach, based on learning from experiences, as well as from other health care organizations, can improve their ability to take on this challenge armed with best practices and lessons learned.

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confidence: 99%

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confidence: 99%

An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

Kiepek

Sengstack

2019

Appl Clin Inform

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“…In the present review Net Benefits refer to barriers and facilitators of ICF use in EHRs. The HOT-fit framework builds upon knowledge based on health and information sciences [27] and has been recommended and recently used for evaluation of health information systems [28][29][30][31][32]. Information relevant to the use of the ICF in an EHR system was extracted and categorized according to the HOT-fit framework using an Excel® spreadsheet.…”

Section: Information Extraction and Descriptive Synthesis Of Resultsmentioning

confidence: 99%

The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records

Maritz¹,

Aronsky²,

Prodinger³

2017

Appl Clin Inform

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Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing. Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.Citation: Maritz R, Aronsky D, Prodinger B. The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records. Appl Clin Inform 2017; 8: 964-980 https://doi.org/10.4338/ACI-2017050078.

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“…In particular, the present study assesses the usability and technological aspects of the ODK Scan supported by the perspective of the field workers in relation to their work settings. However, it is also noted that in the developing country context, a prerequisite to the success of mHealth interventions is the consideration of developers and implementers about the field workers' expectations, needs and work settings [29,30]. Moreover, a gap between the work practices and use of the new technologies is attributed by the poor implementation design of the technology-based interventions [31].…”

Section: Discussionmentioning

confidence: 99%

ODK Scan: Digitizing Data Collection and Impacting Data Management Processes in Pakistan’s Tuberculosis Control Program

Ali¹,

Powers

Beorse

et al. 2016

Future Internet

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Abstract:The present grievous tuberculosis situation can be improved by efficient case management and timely follow-up evaluations. With the advent of digital technology, this can be achieved through quick summarization of the patient-centric data. The aim of our study was to assess the effectiveness of the ODK Scan paper-to-digital system during a testing period of three months. A sequential, explanatory mixed-method research approach was employed to elucidate technology use. Training, smartphones, the application and 3G-enabled SIMs were provided to the four field workers. At the beginning, baseline measures of the data management aspects were recorded and compared with endline measures to determine the impact of ODK Scan. Additionally, at the end of the study, users' feedback was collected regarding app usability, user interface design and workflow changes. A total of 122 patients' records were retrieved from the server and analysed in terms of quality. It was found that ODK Scan recognized 99.2% of multiple choice fill-in bubble responses and 79.4% of numerical digit responses correctly. However, the overall quality of the digital data was decreased in comparison to manually entered data. Using ODK Scan, a significant time reduction is observed in data aggregation and data transfer activities, but data verification and form-filling activities took more time. Interviews revealed that field workers saw value in using ODK Scan, but they were more concerned about the time-consuming aspects of the use of ODK Scan. Therefore, it is concluded that minimal disturbance in the existing workflow, continuous feedback and value additions are the important considerations for the implementing organization to ensure technology adoption and workflow improvements.

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End-user support for primary care electronic medical records: a qualitative case study of users’ needs, expectations, and realities

Cited by 17 publications

References 43 publications

An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records

ODK Scan: Digitizing Data Collection and Impacting Data Management Processes in Pakistan’s Tuberculosis Control Program

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