1 HITECH includes incentives that provide reimbursements to hospitals and healthcare provider practices for adopting certified EHR technology an. Instead, the results indicated the existence of serious problems and deficiencies which considerably hindered the efficiency of EHR use [136]. BMC Med Inform Decis Mak. Gaps between EHR design and the functionality needed in the complex inpatient environment resulted in a lack of standardized workflows [89]. Mind map showing positive (+) and negative () effects of electronic health record (EHR) implementation. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of the study selection process. Electronic health records: Use, barriers and satisfaction among physicians who care for black and Hispanic patients. Perceptions of impact of electronic health records on nurses' work. It is deemed a promising solution to improve the interoperability of patients' information across health-care settings and achieve a more cost-effective, safer, and higher quality of care [3, 6]. Physician Perception of the Role of the Patient Portal in Pediatric Health. Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. Perceived general efficiency gains in workflow [27] and in laboratory turnaround time [29] were found, with these time-consuming tasks related to paper-based records being no longer required [29,41,44]. Greysen S.R., Magan Y., Rosenthal J., Jacolbia R., Auerbach A.D., Harrison J.D. Orfanidis L., Bamidis P.D., Eaglestone B. Effect on VA Patient Satisfaction of Providers Use of an Integrated Viewer of Multiple Electronic Health Records. In the latter case, the patient is given access to the EHR by the care provider without the patient controlling it. http://creativecommons.org/licenses/by/4.0/, http://norden.diva-portal.org/smash/get/diva2:821230/PREVIEW01.jpg, (electronic health record[TIAB] OR EHR[TIAB] OR personal health record[TIAB] OR PHR[TIAB] OR patient record[TIAB]) AND (care pathways[TIAB] OR workflow[TIAB] OR work routines[TIAB] OR workload [TIAB] OR work process[TIAB]) AND ((hasabstract[text] AND loattrfree full text[sb] AND loattrfull text[sb]) AND (2005/01/01[PDAT]: 2020/05/31[PDAT]) AND humans[MeSH Terms] AND English[lang]), (electronic health record[TIAB] OR EHR[TIAB] OR personal health record[TIAB] OR PHR[TIAB] OR patient record[TIAB]) AND (efficiency[TIAB] OR advantages[TIAB] OR disadvantages[TIAB] OR satisfaction[TIAB] OR teamwork[TIAB] OR collaboration[TIAB] OR benefits[TIAB] OR challenges[TIAB]) AND ((hasabstract[text] AND loattrfree full text[sb] AND loattrfull text[sb]) AND (2005/01/01[PDAT]: 2020/05/31[PDAT]) AND humans[MeSH Terms] AND English[lang]), TOPIC: ((electronic health record* OR EHR* OR personal health record* OR PHR* OR patient record*) AND (care pathways OR workflow OR work routines OR workload OR work process)), TOPIC: ((electronic health record* OR EHR* OR personal health record* OR PHR* OR patient record*) AND (efficiency OR advantages OR disadvantages OR satisfaction OR teamwork OR collaboration OR benefits OR challenges)), ((electronic health record* OR EHR* OR personal health record* OR PHR* OR patient record*) AND (care pathways OR workflow OR work routines OR workload OR work process)), ((electronic health record* OR EHR* OR personal health record* OR PHR* OR patient record*) AND (efficiency OR advantages OR disadvantages OR satisfaction OR teamwork OR collaboration OR benefits OR challenges)), (electronic health record* OR EHR* OR personal health record* OR PHR* OR patient record*) AND (care pathways OR workflow OR work routines OR workload OR work process), (electronic health record* OR EHR* OR personal health record* OR PHR* OR patient record*) AND (efficiency OR advantages OR disadvantages OR satisfaction OR teamwork OR collaboration OR benefits OR challenges), Measurement/analysis of EHR usage and/or other data, Other clinicians (e.g., physician assistant, nursing assistant, midwife, lab staff, therapist etc. Some of the barriers with high occurrence suggested in our results are resource constraints, poor/insufficient training and a lack of technical/educational support for users, as well as poor literacy and a lack of skills in technology. EHRs benefits medical practices in a variety of ways, including: Reduced transcription costs Reduced chart pull, storage, and re-filing costs Kutney-Lee A., Sloane D.M., Bowles K.H., Burns L.R., Aiken L.H. A survey-based study of factors that motivate nurses to protect the privacy of electronic medical records. The Author 2015. Burns J. We evaluated the impact of the introduction of an inpatient electronic health record (EHR) on clinical workflow in a high-volume labor and delivery unit in a large university hospital in the United States. Process-related and structural elements of nursing documentation in EHRs were better than paper-based records [123]. Careers, Unable to load your collection due to an error. Hospitals with higher penetration of electronic health records had more RNs employed (coefficient=0.234, P=.002) compared with hospitals with low penetration of electronic health records, even when controlling for adjusted patient-day volumes. Electronic health records and support for primary care teamwork. The Computer-Based Patient Record an Essential Technology for Health Care. Many health care providers have found that electronic health records (EHRs) help improve medical practice management by increasing practice efficiencies and cost savings. Emergency Physicians Perceived Influence of EHR Use on Clinical Workflow and Performance Metrics. Despite the overall positive findings, in more recent research, mixed results and unanticipated negative consequences (e.g., disrupted workflow) were still reported [158]. Nurses reported the difference in workflow in line with how PHR communication was handled in the same clinic [141]. Schenk E., Schleyer R., Jones C.R., Fincham S., Daratha K.B., Monsen K.A. Yeung T. Local health department adoption of electronic health records and health information exchanges and its impact on population health. This was highlighted in a study which showed that the survey respondents (clinicians and staff) perceived a lack of trust in the reliability of EHRs and a lack of belief in their value for patient care to be barriers to EHR implementation (mean score 3.47 out of 5 and 4.46 out of 5) [58]. Exclusion criteria included studies related to secondary use of EHRs, data mining of EHRs, methods for evaluating EHR implementation, and EHR-integrated applications/software/tools. Resource constraints, poor/insufficient training and technical/educational support for users, as well as poor literacy and skills in technology were the identified barriers to adoption and use that occurred frequently. Research shows that EMRs have the potential to reduce instances of medication errors and improve communication between pharmacists and prescribers; however, more research is required to demonstrate whether this is true. EHRs allowing the systematic storage of data and information were mentioned by 80% of the interview respondents (physicians) in one study [43]. Another study found that patients preventive health behaviors were significantly associated with PHR use [80]. Gesulga J.M., Berjame A., Moquiala K.S., Galido A. Patient Recommendations to Improve the Implementation of and Engagement with Portals in Acute Care: Hospital-Based Qualitative Study. Two sources of data were linked and analyzed for years 2007 and 2008: the American Hospital Association survey and the Centers for Medicare & Medicaid Services data. Objective: To assess the impact of electronic health record (EHR) on healthcare quality, we hence carried out a systematic review and meta-analysis of published studies on this topic.Methods: PubMed, Web of Knowledge, Scopus and Cochrane Library databases were searched to identify studies that investigated the association between the EHR implementation and process or outcome indicators. Howard J., Clark E.C., Friedman A., Crosson J.C., Pellerano M., Crabtree B.F., Karsh B.T., Jaen C.R., Bell D.S., Cohen D.J. Hamamura F.D., Withy K., Hughes K. Identifying Barriers in the Use of Electronic Health Records in Hawaii. Patient Portal Service: An Exploration of Patients Experience and Perception; Proceedings of the ICDS 2017: The Eleventh International Conference on Digital Society; Nice, France. This would also enable further measurement of the effects of the implementation of EHR systems and eHealth services in general. Considering the usability and functionality perspectives of EHRs, failing to include key functionalities that support the workflow of the entire care team, such as the exchange of laboratory results and medication lists and tools for chronic disease management and preventive care, led to extra steps in the workflow and reduced efficiency [29,40,44]. Marmor R.A., Clay B., Millen M., Savides T.J., Longhurst C.A. Electronic Health Record implementation in a large academic radiotherapy department: Temporarily disruptions but long-term benefits. In one study [25], interesting downward trends were found in the proportion of clinicians agreeing that EHRs resulted in longer patient visits, from 68% at month 1 post-EHR to 51% at month 12 post-EHR (p = 0.001). sharing sensitive information, make sure youre on a federal Sockolow P.S., Bowles K.H., Adelsberger M.C., Chittams J.L., Liao C. Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes. Health Informatics J. Kariotis T.C., Harris K.M. Chao C.A. You may search for similar articles that contain these same keywords or you may The use of EHRs allowed nurses and aged care staff to rely less on memory or written notes, to check which tasks had been done and which should be carried out, and to develop better care plans [20,28,42,56]. Some error has occurred while processing your request. However, altered workflow emerged as a negative effect [91,112,113,115] related to some of the issues mentioned above, such as poor integration of current workflows in EHRs, poor cross-organizational connectivity in EHRs and communication ambiguity [29,44,47]. Systematic Review, Recommendations, and Novel Model for Health IT Collaboration. Improving the Efficiency of Care for Pediatric Patients Hospitalized with Asthma. Another study reported overall positive perceptions of nurses towards EHRs in perceived use, system quality, and satisfaction [124]. Before Nguyen L., Bellucci E., Nguyen L.T. Yuan N., Dudley R.A., Boscardin W.J., Lin G.A. the contents by NLM or the National Institutes of Health. The goal of this scoping review was to identify currently available evidence and present an overview of the effects of EHR implementation and the barriers to EHR adoption and use. Most barriers identified in this study (e.g., training and technical support, literacy and skill in technology, trust and belief in EHRs, privacy, and resources/costs) are congruent with the findings suggested by recent systematic reviews [161,162]. Despins L.A., Wakefield B.J. In addition, 72% of patients in a study believed PHRs would strengthen the provider patient relationship [132]. performed the initial data analysis independently of each other and S.K. A majority of nurses perceived that EHRs helped them in planning their work [119]. In a study investigating the impact of changing from a longstanding homegrown EHR to a vendor EHR, a significant decrease in the number of participating physicians who agreed that EHR does not interfere with the ability to have face-to-face contact with patients was observed and this trend persisted for 25 months after the implementation of the vendor EHR [137]. Sockolow P.S., Bowles K.H., Lehmann H.P., Abbott P.A., Weiner J.P. Community-Based, Interdisciplinary Geriatric Care Team Satisfaction with an Electronic Health Record A Multimethod Study. 8600 Rockville Pike Koide D., Asonuma M., Naito K., Igawa S., Shimizu S. Evaluation of electronic health records from viewpoint of patients. The Impact of Electronic Health Records on the Duration of Patients Visits: Time and Motion Study.
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