First medical contact and physicians' opinion after the implementation of an electronic record system

Claret, Pierre‐Géraud; Sebbanne, Mustapha; Bobbia, Xavier; Bonnec, Jean-Marie; Pommet, Stéphane; Jebali, Chawki; Coussaye, Jean-Emmanuel de La

doi:10.1016/j.ajem.2011.06.014

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…However, most clinicians refuse to return to handwritten records 63. The apparent increased clinician time required to operate EPRs should be addressed early 64…”

Section: Resultsmentioning

confidence: 99%

What to expect from electronic patient record system implementation: lessons learned from published evidence

Priestman

Sridharan

Vigne

et al. 2018

BMJ Health Care Inform

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BackgroundNumerous studies have examined factors related to success, failure and implications of electronic patient record (EPR) system implementations, but usually limited to specific aspects.ObjectiveTo review the published peer-reviewed literature and present findings regarding factors important in relation to successful EPR implementations and likely impact on subsequent clinical activity.MethodLiterature review.ResultsThree hundred and twelve potential articles were identified on initial search, of which 117 were relevant and included in the review. Several factors were related to implementation success, such as good leadership and management, infrastructure support, staff training and focus on workflows and usability. In general, EPR implementation is associated with improvements in documentation and screening performance and reduced prescribing errors, whereas there are minimal available data in other areas such as effects on clinical patient outcomes. The peer-reviewed literature appears to under-represent a range of technical factors important for EPR implementations, such as data migration from existing systems and impact of organisational readiness.ConclusionThe findings presented here represent the synthesis of data from peer-reviewed literature in the field and should be of value to provide the evidence-base for organisations considering how best to implement an EPR system.

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“…However, most clinicians refuse to return to handwritten records 63. The apparent increased clinician time required to operate EPRs should be addressed early 64…”

Section: Resultsmentioning

confidence: 99%

What to expect from electronic patient record system implementation: lessons learned from published evidence

Priestman

Sridharan

Vigne

et al. 2018

BMJ Health Care Inform

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“…Of the 41 quantitative studies that investigated the clinician experience, 24 (59%) included an overall EMR satisfaction metric, and 71% (17/24) of these studies reported a positive sentiment [ 47 , 49 , 59 , 60 , 62 , 70 , 72 , 73 , 76 , 79 , 80 , 85 , 87 - 89 , 98 , 101 ]. For instance, Kutney-Lee et al [ 76 ] used the registered nurse forecasting study (RN4CAST-US) nursing survey with 12,377 nurses across 353 hospitals and found a 74.9% “satisfaction with current EMR.” In total, 25% (6/24) of the studies [ 64 , 68 , 72 , 75 , 89 , 94 ] used features of the technology acceptance model, and “perceived usefulness” or “perceived value” was equated to overall satisfaction .…”

Section: Resultsmentioning

confidence: 99%

“…A total of 30% (14/41) of the studies discussed the experience of adapting existing workflows to integrate the new digital interface and transitioning to a digital environment on the wards [ 47 , 50 , 56 , 60 , 64 , 66 , 70 , 71 , 75 , 77 , 93 , 98 , 99 , 101 ]. Generally, the adaptation outcome had a negative sentiment from EMR users.…”

Section: Resultsmentioning

confidence: 99%

Section: Clinician Satisfaction With the Emrmentioning

confidence: 99%

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The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis

Canfell,

Woods,

Meshkat

et al. 2024

J Med Internet Res

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Background The digital transformation of health care is advancing rapidly. A well-accepted framework for health care improvement is the Quadruple Aim: improved clinician experience, improved patient experience, improved population health, and reduced health care costs. Hospitals are attempting to improve care by using digital technologies, but the effectiveness of these technologies is often only measured against cost and quality indicators, and less is known about the clinician and patient experience. Objective This study aims to conduct a systematic review and qualitative evidence synthesis to assess the clinician and patient experience of digital hospitals. Methods The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and ENTREQ (Enhancing the Transparency in Reporting the Synthesis of Qualitative Research) guidelines were followed. The PubMed, Embase, Scopus, CINAHL, and PsycINFO databases were searched from January 2010 to June 2022. Studies that explored multidisciplinary clinician or adult inpatient experiences of digital hospitals (with a full electronic medical record) were included. Study quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis was performed narratively for quantitative studies. Qualitative evidence synthesis was performed via (1) automated machine learning text analytics using Leximancer (Leximancer Pty Ltd) and (2) researcher-led inductive synthesis to generate themes. Results A total of 61 studies (n=39, 64% quantitative; n=15, 25% qualitative; and n=7, 11% mixed methods) were included. Most studies (55/61, 90%) investigated clinician experiences, whereas few (10/61, 16%) investigated patient experiences. The study populations ranged from 8 to 3610 clinicians, 11 to 34,425 patients, and 5 to 2836 hospitals. Quantitative outcomes indicated that clinicians had a positive overall satisfaction (17/24, 71% of the studies) with digital hospitals, and most studies (11/19, 58%) reported a positive sentiment toward usability. Data accessibility was reported positively, whereas adaptation, clinician-patient interaction, and workload burnout were reported negatively. The effects of digital hospitals on patient safety and clinicians’ ability to deliver patient care were mixed. The qualitative evidence synthesis of clinician experience studies (18/61, 30%) generated 7 themes: inefficient digital documentation, inconsistent data quality, disruptions to conventional health care relationships, acceptance, safety versus risk, reliance on hybrid (digital and paper) workflows, and patient data privacy. There was weak evidence of a positive association between digital hospitals and patient satisfaction scores. Conclusions Clinicians’ experience of digital hospitals appears positive according to high-level indicators (eg, overall satisfaction and data accessibility), but the qualitative evidence synthesis revealed substantive tensions. There is insufficient evidence to draw a definitive conclusion on the patient experience within digital hospitals, but indications appear positive or agnostic. Future research must prioritize equitable investigation and definition of the digital clinician and patient experience to achieve the Quadruple Aim of health care.

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“…The causes of overcrowding are multiple and intertwined, but increased delays in care seem to have a major impact on ED flow [ 3 , 4 ]. To analyze this issue, important variables to consider include the delay to first medical contact (FMC) [ 5 ] and the length of stay (LOS) in the ED [ 3 ]. These times are recognized as indicators of overcrowding and can be considered targets on which to act to improve outcomes for ED patients [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of emergency department segmentation and nursing staffing increase on inpatient mortality and management times

Claret

Bobbia

Olive

et al. 2016

BMC Health Serv Res

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BackgroundThe aim of our study was to investigate the impact of a new organization of our emergency department (ED) on patients’ mortality and management delays.MethodsThe ED segmentation consisted of the development of a new patient care geographical layout on a pre-existing site and changing the organization of patient flow. It took place on May 10, 2012. We did a before-after study in the ED of a university hospital, “before” (winter 2012) and “after” (summer 2012) reorganization by segmentation into sectors. All ED patients were included.ResultsEighty-three thousand three hundred twenty-two patient visits were analyzed, 61,118 in phase “before”, 22,204 during the phase “after”. The overall inpatient mortality was 1.5 % during summer 2011 (“before” period), 1.8 % during winter 2012 (“before” period), 1.3 % during summer 2012 (“after” period) period (summer 2012 vs. winter 2012, OR = 0.72; 95 % CIs [0.61, 0.85], and summer 2012 vs. summer 2011, OR = 0.85; 95 % CIs [0.72, 0.99]). The mean (SD) time to first medical contact was 129 min (±133) during winter 2012 and 104 min (± 95) during summer 2012 (p < .05).ConclusionsOur study showed a decrease in mortality and improvement in time to first medical contact after the segmentation of our ED and nursing staffing increase, without an increase in medical personnel. Improving patient care through optimizing ED segmentation may be an effective strategy.

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First medical contact and physicians' opinion after the implementation of an electronic record system

Cited by 6 publications

References 21 publications

What to expect from electronic patient record system implementation: lessons learned from published evidence

What to expect from electronic patient record system implementation: lessons learned from published evidence

The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis

The impact of emergency department segmentation and nursing staffing increase on inpatient mortality and management times

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