Exploring association between certified EHRs adoption and patient experience in U.S. psychiatric hospitals

Hu, Xuejun; Qu, Haiyan; Houser, Shannon H.; Ding, Jingmei; Chen, Huoliang; Zhang, Xianzhi; Yu, Min

doi:10.1371/journal.pone.0234607

Cited by 9 publications

(19 citation statements)

References 43 publications

(63 reference statements)

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“…There is some evidence that EHRs can improve service users’ experience of integrated care. Hu et al [ 90 ] found that EHR adoption was significantly associated with improved service user experience for "care transition" and "discharge information" in psychiatric hospitals. Jetelina et al [ 110 ] also found a significant improvement in service users’ perceptions of integrated care after the implementation of a mental health–specific EHR.…”

Section: Resultsmentioning

confidence: 99%

“…Most were quantitative (21/40, 53%) [ 78 - 98 ], with qualitative (11/40, 28%) [ 99 - 109 ] and mixed method studies (8/40, 20%) [ 110 - 117 ] also included. We categorized studies based on the broad category of research methods, including surveys (15/40, 38%) [ 78 , 80 - 85 , 89 , 92 , 95 - 97 , 110 , 113 , 116 ], qualitative interview/focus group studies (7/40, 18%) [ 100 - 104 , 110 , 111 ], chart review of specific EHRs (5/40, 13%) [ 85 - 87 , 114 , 117 ], cross-sectional analysis of EHR data or comparison with other secondary data (5/40, 13%) [ 90 , 91 , 93 , 95 , 98 ], quality improvement initiatives (3/40, 8%) [ 79 , 88 , 111 ], ethnographic or observational (6/40, 15%) [ 99 , 105 - 108 , 112 ], and descriptive case studies (1/40, 3%) [ 109 ].…”

Section: Methodsmentioning

confidence: 99%

“…Most studies took place in the United States (27/40, 68%) [ 80 - 83 , 85 - 90 , 92 - 98 , 101 , 102 , 104 , 106 , 110 - 113 , 115 , 116 ], followed by the United Kingdom (8/40, 20%) [ 78 , 84 , 99 , 100 , 105 , 107 , 108 , 117 ]. Canada (2/40, 5%) [ 79 , 114 ], France (1/40, 3%) [ 103 ], Brazil (1/40, 3%), and Ireland (1/40, 3%) [ 91 ] were also represented in the included studies.…”

Section: Methodsmentioning

confidence: 99%

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Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review

Kariotis¹,

Prictor²,

Chang³

et al. 2022

J Med Internet Res

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Background The adoption of electronic health records (EHRs) and electronic medical records (EMRs) has been slow in the mental health context, partly because of concerns regarding the collection of sensitive information, the standardization of mental health data, and the risk of negatively affecting therapeutic relationships. However, EHRs and EMRs are increasingly viewed as critical to improving information practices such as the documentation, use, and sharing of information and, more broadly, the quality of care provided. Objective This paper aims to undertake a scoping review to explore the impact of EHRs on information practices in mental health contexts and also explore how sensitive information, data standardization, and therapeutic relationships are managed when using EHRs in mental health contexts. Methods We considered a scoping review to be the most appropriate method for this review because of the relatively recent uptake of EHRs in mental health contexts. A comprehensive search of electronic databases was conducted with no date restrictions for articles that described the use of EHRs, EMRs, or associated systems in the mental health context. One of the authors reviewed all full texts, with 2 other authors each screening half of the full-text articles. The fourth author mediated the disagreements. Data regarding study characteristics were charted. A narrative and thematic synthesis approach was taken to analyze the included studies’ results and address the research questions. Results The final review included 40 articles. The included studies were highly heterogeneous with a variety of study designs, objectives, and settings. Several themes and subthemes were identified that explored the impact of EHRs on information practices in the mental health context. EHRs improved the amount of information documented compared with paper. However, mental health–related information was regularly missing from EHRs, especially sensitive information. EHRs introduced more standardized and formalized documentation practices that raised issues because of the focus on narrative information in the mental health context. EHRs were found to disrupt information workflows in the mental health context, especially when they did not include appropriate templates or care plans. Usability issues also contributed to workflow concerns. Managing the documentation of sensitive information in EHRs was problematic; clinicians sometimes watered down sensitive information or chose to keep it in separate records. Concerningly, the included studies rarely involved service user perspectives. Furthermore, many studies provided limited information on the functionality or technical specifications of the EHR being used. Conclusions We identified several areas in which work is needed to ensure that EHRs benefit clinicians and service users in the mental health context. As EHRs are increasingly considered critical for modern health systems, health care decision-makers should consider how EHRs can better reflect the complexity and sensitivity of information practices and workflows in the mental health context.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review

Kariotis¹,

Prictor²,

Chang³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

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“…System affiliation (Hu et al, 2020) Bed size (Hu et al, 2020) Teaching status (Hu et al, 2020) Care Transition (n = 2 studies)…”

Section: Structurementioning

confidence: 99%

“…Advanced practice provider/care pathways (Broman, 2021) Certified electronic health records (Hu et al, 2020) Structure Rural status (Hu et al, 2020) Nonprofit (Hu et al, 2020)…”

Section: Processmentioning

confidence: 99%

Interventions and Hospital Characteristics Associated With Patient Experience: An Update of the Evidence

Beckett,

Quigley,

Lehrman

et al. 2024

Med Care Res Rev

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Patient experience is a key hospital quality measure. We review and characterize the literature on interventions, care and management processes, and structural characteristics associated with better inpatient experiences as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Prior reviews identified several promising interventions. We update these previous efforts by including more recent peer-reviewed literature and expanding the review’s scope to include observational studies of HCAHPS measures with process measures and structural characteristics. We used PubMed to identify U.S. English-language peer-reviewed articles published in 2017 to 2020 and focused on hospital patient experience. The two HCAHPS domains for which we found the fewest potential quality improvement interventions were Communication with Doctors and Quietness. We identified several modifiable processes that could be rigorously evaluated in the future, including electronic health record patient engagement functionality, care management processes, and nurse-to-patient ratios. We describe implications for future policy, practice, and research.

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Gaps and Direction for Digital Records Impacting the Mental Health Patient-Provider Dyad: A Systematic Review

Cohen,

Langabeer,

Lopez

et al. 2024

J Contemp Psychother

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Exploring association between certified EHRs adoption and patient experience in U.S. psychiatric hospitals

Cited by 9 publications

References 43 publications

Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review

Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review

Interventions and Hospital Characteristics Associated With Patient Experience: An Update of the Evidence

Gaps and Direction for Digital Records Impacting the Mental Health Patient-Provider Dyad: A Systematic Review

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