Stress management in staff supporting electronic health record transitions: A novel approach

Adusumalli, Jayanth; Vitek, Sairey; Clark, Stephanie; Chon, Tony Y.

doi:10.1016/j.explore.2020.03.008

Cited by 2 publications

(2 citation statements)

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“…Such experiences can negatively affect the patient-clinician relationship. Preparing clinicians and patients about an upcoming transition, including technical support for clinicians and patients, may help minimize these potential issues [10,27]. Specialized training about an impending transition, along with detailed instructions on how to gain access to the new system, and a dedicated portal helpline may be necessary to help patients better navigate the transition [23,28].…”

Section: Preparementioning

confidence: 99%

Clinician and staff experiences with frustrated patients during an electronic health record transition: a qualitative case study

Ball,

Kim,

Cutrona

et al. 2024

BMC Health Serv Res

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Background Electronic health record (EHR) transitions are known to be highly disruptive, can drastically impact clinician and staff experiences, and may influence patients’ experiences using the electronic patient portal. Clinicians and staff can gain insights into patient experiences and be influenced by what they see and hear from patients. Through the lens of an emergency preparedness framework, we examined clinician and staff reactions to and perceptions of their patients’ experiences with the portal during an EHR transition at the Department of Veterans Affairs (VA). Methods This qualitative case study was situated within a larger multi-methods evaluation of the EHR transition. We conducted a total of 122 interviews with 30 clinicians and staff across disciplines at the initial VA EHR transition site before, immediately after, and up to 12 months after go-live (September 2020-November 2021). Interview transcripts were coded using a priori and emergent codes. The coded text segments relevant to patient experience and clinician interactions with patients were extracted and analyzed to identify themes. For each theme, recommendations were defined based on each stage of an emergency preparedness framework (mitigate, prepare, respond, recover). Results In post-go-live interviews participants expressed concerns about the reliability of communicating with their patients via secure messaging within the new EHR portal. Participants felt ill-equipped to field patients’ questions and frustrations navigating the new portal. Participants learned that patients experienced difficulties learning to use and accessing the portal; when unsuccessful, some had difficulties obtaining medication refills via the portal and used the call center as an alternative. However, long telephone wait times provoked patients to walk into the clinic for care, often frustrated and without an appointment. Patients needing increased in-person attention heightened participants’ daily workload and their concern for patients’ well-being. Recommendations for each theme fit within a stage of the emergency preparedness framework. Conclusions Application of an emergency preparedness framework to EHR transitions could help address the concerns raised by the participants, (1) mitigating disruptions by identifying at-risk patients before the transition, (2) preparing end-users by disseminating patient-centered informational resources, (3) responding by building capacity for disrupted services, and (4) recovering by monitoring integrity of the new portal function.

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Section: Preparementioning

confidence: 99%

Clinician and staff experiences with frustrated patients during an electronic health record transition: a qualitative case study

Ball,

Kim,

Cutrona

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Preparing clinicians and patients about an upcoming transition, including technical support for clinicians and patients, may help minimize these potential issues. 20,21 Specialized training about an impending transition, along with detailed instructions on how to gain access to the new system, and a dedicated portal helpline may be necessary to help patients better navigate the transition. 22…”

Section: Preparementioning

confidence: 99%

Clinician and Staff Experiences with Frustrated Patients during an Electronic Health Record Transition: A Qualitative Case Study

Ball,

Kim,

Cutrona

et al. 2023

Preprint

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Background: Electronic health record (EHR) transitions are known to be highly disruptive, can drastically impact clinician and staff experiences, and may influence patients’ experiences using the electronic patient portal. Clinicians and staff can gain insights into patient experiences and be influenced by what they see and hear from patients. Through the lens of an emergency preparedness framework, we examined clinician and staff reactions to and perceptions of their patients’ experiences with the portal during an EHR transition at the Department of Veterans Affairs (VA). Methods: This qualitative case study was situated within a larger multi-methods evaluation of the EHR transition. We conducted a total of 122 interviews with 30 clinicians and staff across disciplines at the initial VA EHR transition site before, immediately after, and up to 12 months after go-live (September 2020-November 2021). Interview transcripts were coded using a priori and emergent codes. The coded text segments relevant to patient experience and clinician interactions with patients were extracted and analyzed to identify themes. For each theme, recommendations were defined based on each stage of an emergency preparedness framework (mitigate, prepare, respond, recover). Results: Participants expressed concerns about the reliability of communicating with their patients via secure messaging within the new EHR portal. Participants felt ill-equipped to field patients’ questions and frustrations navigating the new portal. Participants learned that patients experienced difficulties learning to use and accessing the portal; when unsuccessful, some had difficulties obtaining medication refills via the portal and used the call center as an alternative. However, long telephone wait times provoked patients to walk into the clinic for care, often frustrated and without an appointment. Patients needing increased in-person attention heightened participants’ daily workload and their concern for patients’ well-being. Recommendations for each theme fit within a stage of the emergency preparedness framework. Conclusions: Application of an emergency preparedness framework to EHR transitions could help address the concerns raised by the participants, 1) mitigating disruptions by identifying at-risk patients before the transition, 2) preparing end-users by disseminating patient-centered informational resources, 3) responding by building capacity for disrupted services, and 4) recovering by monitoring integrity of the new portal function.

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Stress management in staff supporting electronic health record transitions: A novel approach

Cited by 2 publications

References 0 publications

Clinician and staff experiences with frustrated patients during an electronic health record transition: a qualitative case study

Clinician and staff experiences with frustrated patients during an electronic health record transition: a qualitative case study

Clinician and Staff Experiences with Frustrated Patients during an Electronic Health Record Transition: A Qualitative Case Study

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