TY - JOUR
T1 - Physician experiences transitioning between an older versus newer electronic health record for electronic prescribing
AU - Abramson, Erika L.
AU - Patel, Vaishali
AU - Malhotra, Sameer
AU - Pfoh, Elizabeth R.
AU - Nena Osorio, S.
AU - Cheriff, Adam
AU - Cole, Curt L.
AU - Bunce, Arwen
AU - Ash, Joan
AU - Kaushal, Rainu
N1 - Funding Information:
The authors thank Adam Wilcox, PhD, and Drs. Fran Ganz-Lord, Lisa Kern, Curtis Cole, James Hollenberg, and Anne-Lise Yohay for assistance with enrolling and interviewing physicians and reviewing data collection instruments. The authors also thank Alison Edwards, MS. This project was supported by AHRQ ( R18HS017029 ), Rockville, MD. None of the authors have any financial conflicts of interest.
PY - 2012/8
Y1 - 2012/8
N2 - Purpose: Federal incentives to adopt interoperable, certified electronic health records (EHRs) with electronic prescribing (e-prescribing) are motivating providers using older EHRs to transition to newer EHRs. The objective of this study was to describe, from the perspective of experienced EHR users, the transition from an older, locally developed EHR with minimal clinical decision support (CDS) for e-prescribing to a newer, commercial EHR with more robust CDS for e-prescribing. Methods: This qualitative, case study consisted of observations and semi-structured interviews of adult internal medicine faculty members (n= 19) at an academic-affiliated ambulatory care clinic from January through November 2009. All providers transitioned from the older, locally developed EHR to the newer, commercial EHR in April 2008. We analyzed field notes of observations and transcripts of semi-structured interviews using qualitative methods guided by a grounded theory approach. Results: We identified key themes describing physician experiences. Despite intensive effort by the information systems team to ease the transition, even these experienced e-prescribers found transitioning extremely difficult. The commercial EHR was not perceived as improving medication safety, despite having more robust CDS. Additionally, physicians felt the commercial EHR was too complex, reducing their efficiency. Conclusions: This is among the first studies examining physician experiences transitioning between an older, locally developed EHR to a newer, commercial EHR with more robust CDS for e-prescribing. Understanding physician experiences with this type of transition and their general preferences for prescribing applications may lead to less disruptive system implementations and better designed EHRs that are more readily accepted by providers. In this way, productivity and safety benefits may be maximized while mitigating potential threats associated with transitions. Trial registration: ClinicalTrials.gov, Identifier: NCT00603070.
AB - Purpose: Federal incentives to adopt interoperable, certified electronic health records (EHRs) with electronic prescribing (e-prescribing) are motivating providers using older EHRs to transition to newer EHRs. The objective of this study was to describe, from the perspective of experienced EHR users, the transition from an older, locally developed EHR with minimal clinical decision support (CDS) for e-prescribing to a newer, commercial EHR with more robust CDS for e-prescribing. Methods: This qualitative, case study consisted of observations and semi-structured interviews of adult internal medicine faculty members (n= 19) at an academic-affiliated ambulatory care clinic from January through November 2009. All providers transitioned from the older, locally developed EHR to the newer, commercial EHR in April 2008. We analyzed field notes of observations and transcripts of semi-structured interviews using qualitative methods guided by a grounded theory approach. Results: We identified key themes describing physician experiences. Despite intensive effort by the information systems team to ease the transition, even these experienced e-prescribers found transitioning extremely difficult. The commercial EHR was not perceived as improving medication safety, despite having more robust CDS. Additionally, physicians felt the commercial EHR was too complex, reducing their efficiency. Conclusions: This is among the first studies examining physician experiences transitioning between an older, locally developed EHR to a newer, commercial EHR with more robust CDS for e-prescribing. Understanding physician experiences with this type of transition and their general preferences for prescribing applications may lead to less disruptive system implementations and better designed EHRs that are more readily accepted by providers. In this way, productivity and safety benefits may be maximized while mitigating potential threats associated with transitions. Trial registration: ClinicalTrials.gov, Identifier: NCT00603070.
KW - Ambulatory care
KW - Clinical decision support
KW - Electronic health record
KW - Physician
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U2 - 10.1016/j.ijmedinf.2012.02.010
DO - 10.1016/j.ijmedinf.2012.02.010
M3 - Article
C2 - 22465355
AN - SCOPUS:84863780009
SN - 1386-5056
VL - 81
SP - 539
EP - 548
JO - International Journal of Medical Informatics
JF - International Journal of Medical Informatics
IS - 8
ER -