A Qualitative Analysis of the Impact of Electronic Health Records (EHR) on Healthcare Quality and Safety: Clinicians' Lived Experiences

电子健康记录(EHR)对医疗保健质量和安全影响的定性分析:临床医生的亲身经历

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Abstract

PURPOSE: There have been mixed findings of clinicians' perceptions of Electronic Health Record (EHR). This study aims to explore the lived experiences of clinicians, to assess the role of EHR in improving the quality and safety of healthcare. BASIC PROCEDURES: A qualitative study design was used. We collected the opinions from different groups of clinicians (physicians, hospitalists, nurse practitioners, nurses, and patient safety officers) using semi-structured interviews. Organizations represented were trauma hospitals, academic medical centers, medical clinics, home health centers, and small hospitals. MAIN FINDINGS: Our study found clinicians' ambivalent assessments toward EHR, which confirms extant literature. We compared the responses by job roles and found that nurses were positive about improving efficiency with EHR while others regarded EHR as time-consuming. While many underscored the importance of EHR in avoiding medical errors by improving data accessibility, nurses had concerns regarding data accuracy. Interoperability appeared to be a concern given limited system integration. PRINCIPAL CONCLUSIONS: Lived experiences of clinicians further tease out the mixed views about the effectiveness of EHR and highlight the challenges in EHR implementation. Redesigning the EHR and improving its implementation process may be potential solutions to increase its effectiveness.

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