Evaluating a post-implementation electronic medical record training intervention for diabetes management in primary care

Randhawa, Gurprit K.; Shachak, Aviv; Courtney, Karen L.; Kushniruk, André

doi:10.1136/bmjhci-2019-100086

Cited by 12 publications

(20 citation statements)

References 37 publications

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“…2 ): 5 were conducted in the United States [ 7 , 37 – 40 ], 7 were conducted in Canada [ 10 , 16 , 18 , 41 – 44 ], 1 was conducted in Israel [ 45 ], and 1 was an international study [ 3 ] conducted in 10 countries, including Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the United Kingdom, and the United States. The studies were methodologically diverse, including 4 qualitative studies [ 7 , 18 , 44 , 45 ], 6 cross-sectional studies [ 3 , 37 , 39 , 41 – 43 ], 3 mixed-methods studies [ 10 , 16 , 38 ], and 1 quantitative descriptive study [ 40 ]. These studies were published between 2009 and 2019 (see Table 2 for full study details).…”

Section: Resultsmentioning

confidence: 99%

“…As such, clinicians using certified EMRs must report information on the quality of care, and other measures and specific objectives were set out for clinicians to mature in their use of EMR features [ 9 ]. In Canada, “meaningful use” has been used to study mature use of EMRs [ 10 ]. In the province of Ontario, OntarioMD, a cooperative owned by the Ontario Medical Association and funded by the provincial government, certifies EMRs and aims to increase the mature use of EMRs in the province [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review

Rahal

Mercer

Yaya

2021

BMC Med Inform Decis Mak

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Background Despite a substantial increase in the adoption of electronic medical records (EMRs) in primary health care settings, the use of advanced EMR features is limited. Several studies have identified both barriers and facilitating factors that influence primary care physicians’ (PCPs) use of advanced EMR features and the maturation of their EMR use. The purpose of this study is to explore and identify the factors that impact PCPs’ mature use of EMRs. Methods A systematic review was conducted in accordance with the Cochrane Handbook. The MEDLINE, Embase, and PsycINFO electronic databases were searched from 1946 to June 13, 2019. Two independent reviewers screened the studies for eligibility; to be included, studies had to address factors influencing PCPs’ mature use of EMRs. A narrative synthesis was conducted to collate study findings and to report on patterns identified across studies. The quality of the studies was also appraised. Results Of the 1893 studies identified, 14 were included in this study. Reported factors that influenced PCPs’ mature use of EMRs fell into one of the following 5 categories: technology, people, organization, resources, and policy. Concerns about the EMR system’s functionality, lack of physician awareness of EMR functionality, limited physician availability to learn more about EMRs, the habitual use of successfully completing clinical tasks using only basic EMR features, business-oriented organizational objectives, lack of vendor training, limited resource availability, and lack of physician readiness were reported as barriers to PCPs’ mature use of EMRs. The motivation of physicians, user satisfaction, coaching and peer mentoring, EMR experience, gender, physician perception, transition planning for changes in roles and work processes, team-based care, adequate technical support and training, sharing resources, practices affiliated with an integrated delivery system, financial incentives, and policies to increase EMR use all had a favorable impact on PCPs’ use of advanced EMR features. Conclusions By using a narrative synthesis to synthesize the evidence, we identified interrelated factors influencing the mature use of EMRs by PCPs. The findings underline the need to provide adequate training and policies that facilitate the mature use of EMRs by PCPs. Trial registration: PROSPERO CRD42019137526.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review

Rahal

Mercer

Yaya

2021

BMC Med Inform Decis Mak

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“…The quantitative results of the mixed methods study (i.e., efficacy of the video tutorial intervention) are reported in a companion paper. 23…”

Section: Methodsmentioning

confidence: 99%

“…This timing coincided with the quantitative data collection time points of the larger mixed methods study. 23 Data were collected using an open-ended question ("please feel free to share any comments regarding your use of the EMR for diabetes care management") included within a quantitative Diabetes Care Questionnaire (DCQ) at O1-O4. Semistructured interviews with participants were held at O3 and O4 to understand (1) PCPs' views of the video tutorials, (2) barriers and facilitators to applying the video tutorials to PCPs' practice, and (3) opportunities to improve the design of the video tutorials (►Tables 3 and 4).…”

Section: Data Collectionmentioning

confidence: 99%

Effective Design, Development, and Evaluation of Video Tutorials for Electronic Medical Record Training

et al. 2020

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Background Electronic medical record (EMR) use by primary care physicians (PCP) in the United States and Canada is suboptimal, especially for supporting chronic diseases like diabetes. PCPs need postimplementation training to achieve value-adding EMR use. Video tutorials demonstrate how to accomplish tasks using software. However, there is a dearth of research on the use of video tutorials for EMR training. Objective The purpose of the study was to design, develop, and evaluate video tutorials for training PCPs in using EMR advanced features for diabetes care. This study addressed three research questions related to PCP's views of video tutorials as an EMR training method/approach, barriers, and facilitators to applying the EMR video tutorials to PCPs' practice, and how the design of EMR video tutorials can be improved. Methods The overall research study employed a QUAN (qual) mixed methods approach with an embedded design. This article focuses on the qualitative phase of the mixed methods study. A series of four theory-informed and evidence-based video tutorials for diabetes care was developed with a physician champion. Qualitative data were collected at four time points: 1 month before (O1), immediately before (O2), 3 months after (O3), and 6 months (O4) after the intervention. Semistructured interviews with participants were held at O3 and O4. Qualitative data were analyzed using thematic analysis. Results In total, 14 PCPs from the overall study participated in interviews (78%). The thematic analysis of the qualitative data revealed seven themes, which fall into two main categories: (1) design and development of EMR video tutorials, and (2) adoption and use of EMR video tutorials. Conclusion PCPs liked the EMR video tutorials for diabetes care, and would like more EMR video tutorials on various topics and EMR use levels. The study offers a roadmap for health informatics professionals everywhere to develop EMR training videos that meet evidence-based design criteria. It also help to identify opportunities to improve the design, delivery, and adoption of EMR video tutorials for future training interventions.

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“…Participating PCPs liked the video tutorial instruction and suggested it would be a useful approach to teach other EMR topics. 24 Although these are encouraging results, the limitations of video tutorials include development time (eg, script development, recording, and editing of video tutorials) and technical requirements (eg, screencasting software and good audio quality).…”

Section: Approach 2: Video Tutorialsmentioning

confidence: 99%

Educational approaches for improving physicians’ use of health information technology

Shachak

Randhawa

Crampton

2019

Healthc Manage Forum

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The benefits of Health Information Technology (HIT) depend on the way they are being used. Education and training are often needed to move from basic to advanced, value-adding, use. In this article, we describe three educational approaches that can help in achieving this goal: “productive failure,” video tutorials, and simulation. We describe the rationale behind these approaches, their strengths, and limitations and illustrate their application, respectively, to three problems associated with the use of HIT in clinical practice: improving data quality within Electronic Medical Records (EMRs) at the point of data entry, use of advanced EMR features for chronic disease management, and impact of the EMR on patient-clinician communication. We conclude that, while these approaches are promising, there is a need for innovation and diversity of educational approaches to address use of advanced HIT features, identified challenges with HIT, and usage in context—as well as for rigorous evaluation.

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Evaluating a post-implementation electronic medical record training intervention for diabetes management in primary care

Cited by 12 publications

References 37 publications

Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review

Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review

Effective Design, Development, and Evaluation of Video Tutorials for Electronic Medical Record Training

Educational approaches for improving physicians’ use of health information technology

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