User Perspectives on Barriers and Facilitators to the Implementation of Electronic Health Records in Behavioral Hospitals: Qualitative Study

Jung, Sung Il; Lee, Kee Hyuck; Lee, Dong-Hyun; Yoo, Sooyoung; Lim, Kahyun; Lee, Ho‐Young; Kim, Eric

doi:10.2196/18764

Cited by 27 publications

(41 citation statements)

References 24 publications

(29 reference statements)

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“…Furthermore, lower digital competence (ie, computer proficiency) has been found to be a barrier to successful implementation of electronic health records in psychiatric hospitals [ 11 ]. This would imply that Swiss psychiatric hospitals have a good precondition for the successful implementation of digital technologies, as the digital competence of health professionals was rated high.…”

Section: Discussionmentioning

confidence: 99%

“…The demands for digital competences and associated changes in the role of health professionals also require a change in the perception of and attitude toward digital resources in everyday work [ 11 ]. Consequently, this transformation may have a stress-inducing effect on health professionals, especially because psychiatric health professionals tend to be hesitant regarding new technologies because of the expected deleterious effects on the relationship between health professionals and patients [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Technostress and Digital Competence Among Health Professionals in Swiss Psychiatric Hospitals: Cross-sectional Study

Golz¹,

Peter²,

Müller³

et al. 2021

JMIR Ment Health

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Background Psychiatric hospitals are becoming increasingly digitized because of the disruptive rise in technical possibilities. This digitization leads to new tasks and demands for health professionals, which can have an impact on technostress. It is unclear whether digital competence reduces technostress and how technostress affects health professionals’ mental and physical health. Objective This study aims to assess the association between digital competence and technostress, considering individual characteristics and the association between technostress and long-term consequences for health professionals. Methods Cross-sectional data from 3 Swiss psychiatric hospitals were analyzed using multiple linear regression. The dependent variables for the models were digital competence, technostress, and long-term consequences (intention to leave the organization or the profession, burnout symptoms, job satisfaction, general health status, quality of sleep, headaches, and work ability). One model was calculated for each long-term consequence. The mean scores for technostress and digital competence could range between 0 (fully disagree) and 4 (fully agree), where a high value for technostress indicated high technostress and a high value for digital competence indicated high digital competence. Results The sample comprised 493 health professionals in psychiatric hospitals. They rated their technostress as moderate (mean 1.30, SD 0.55) and their digital competence as high (mean 2.89, SD 0.73). Digital competence was found to be significantly associated with technostress (β=−.20; P<.001). Among the individual characteristics, age (β=.004; P=.03) and profession were significantly associated with both digital competence and technostress. Technostress is a relevant predictor of burnout symptoms (β=10.32; P<.001), job satisfaction (β=−6.08; P<.001), intention to leave the profession (β=4.53; P=.002), organization (β=7.68; P<.001), general health status (β=−4.47; P<.001), quality of sleep (β=−5.87; P<.001), headaches (β=6.58; P<.001), and work ability (β=−1.40; P<.001). Conclusions Physicians and nurses who have more interaction with digital technologies rate their technostress higher and their digital competence lower than those in other professions. Health professionals with low interaction with digital technologies appear to overestimate their digital competence. With increasing digitization in psychiatric hospitals, an increase in the relevance of this topic is expected. Educational organizations and psychiatric hospitals should proactively promote the digital competence of health professionals to manage expected disruptive changes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Technostress and Digital Competence Among Health Professionals in Swiss Psychiatric Hospitals: Cross-sectional Study

Golz¹,

Peter²,

Müller³

et al. 2021

JMIR Ment Health

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“…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%

“…We first identified studies that expected to report the details of the EHR in their methods sections, such as the evaluations of specific EHRs (28/40, 70%) [ 78 , 79 , 81 - 84 , 87 - 89 , 91 , 92 , 95 , 99 - 111 , 114 , 115 , 117 ]. Of these 28 studies, 16 (57%) either named the EHR or provided details as to whether it was custom built or off the shelf [ 78 , 79 , 83 , 84 , 89 , 95 , 99 - 102 , 105 - 108 , 110 , 117 ]. One of the studies pointed to other publications in which the details of the EHR were reported [ 103 ].…”

Section: Methodsmentioning

confidence: 99%

“…Some papers did not provide these details, and we searched for further information on the web to categorize those EHRs. Of the 16 studies that reported on the EHR, 3 (19%) were custom built [ 89 , 106 , 117 ], 12 (75%) were off the shelf [ 78 , 79 , 83 , 84 , 95 , 99 - 102 , 107 , 108 , 110 ], and 1 (6%) was unclear [ 105 ]. The common off-the-shelf models were RiO [ 84 , 99 , 100 , 107 , 108 ] and EPIC [ 95 , 110 ].…”

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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Medical Records, Electronic/Patient Portals

Volkman¹,

Clements²

2022

The International Encyclopedia of Health Communication

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User Perspectives on Barriers and Facilitators to the Implementation of Electronic Health Records in Behavioral Hospitals: Qualitative Study

Cited by 27 publications

References 24 publications

Technostress and Digital Competence Among Health Professionals in Swiss Psychiatric Hospitals: Cross-sectional Study

Technostress and Digital Competence Among Health Professionals in Swiss Psychiatric Hospitals: Cross-sectional Study

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

Medical Records, Electronic/Patient Portals

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