Medical and nursing clinician perspectives on the usability of the hospital electronic medical record: A qualitative analysis

Abstract

Background Electronic medical records (EMRs) have been widely implemented in Australian hospitals. Their usability and design to support clinicians to effectively deliver and document care is essential, as is their impact on clinical workflow, safety and quality, communication, and collaboration across health systems. Perceptions of, and data about, usability of EMRs implemented in Australian hospitals are key to successful adoption. Objective To explore perspectives of medical and nursing clinicians on EMR usability utilising free-text data collected in a survey. Method Qualitative analysis of one free-text optional question included in a web-based survey. Respondents included medical and nursing/midwifery professionals in Australian hospitals (85 doctors and 27 nurses), who commented on the usability of the main EMR used. Results Themes identified related to the status of EMR implementation, system design, human factors, safety and risk, system response time, and stability, alerts, and supporting the collaboration between healthcare sectors. Positive factors included ability to view information from any location; ease of medication documentation; and capacity to access diagnostic test results. Usability concerns included lack of intuitiveness; complexity; difficulties communicating with primary and other care sectors; and time taken to perform clinical tasks. Conclusion If the benefits of EMRs are to be realised, there are good reasons to address the usability challenges identified by clinicians. Easy solutions that could improve the usability experience of hospital-based clinicians include resolving sign-on issues, use of templates, and more intelligent alerts and warnings to avoid errors. Implications These essential improvements to the usability of the EMR, which are the foundation of the digital health system, will enable hospital clinicians to deliver safer and more effective health care.

Clinical documentation integrity: Its role in health data integrity, patient safety and quality outcomes and its impact on clinical coding and health information management

“…While challenges exist, there is clear potential and interest in optimising data captured as electronic forms of clinical documentation; however, its integrity remains critical. Several articles considered the usability of EHR documentation from clinician perspectives (Lloyd et al, 2023;Payton et al, 2023). Lloyd et al (2023) focused on situational factors impacting clinicians such as increasing complexity, work pressures, burnout and highlighting challenges identified by clinicians related to EMR such as usability, lack of intuitiveness, complexity, difficulties communicating with primary and other care sectors and time taken to perform clinical tasks.…”

Challenges and successes in implementing an integrated electronic patient record (HIVE) at the Manchester University National Health Service Foundation Trust, England: 1000+ legacy systems, 10 hospitals, one electronic patient record

“…Successful integration of systems also depends on collaboration and a willingness to share data among users. Lloyd et al (2023: 1) explored perspectives of medical and nursing clinicians on the usability of an EMR. Perceived benefits related to “system design, human factors, safety and risk, system response time, and stability, alerts, and supporting the collaboration between healthcare sectors.” Krahe et al (2023) examined the data sharing practices of 77 researchers from one institute in relation to barriers and facilitators of target behaviours that encourage data sharing.…”