JAMIA: EHR vendors need to keep up with practice upgrades
To ensure practitioners' expectations—for instance, regarding improvements in medication safety—are met, vendors should develop and implement refinements in their software as practices upgrade to newer, certified EHRs, was the finding of a recent clinical study published Aug. 28 online in the Journal of the American Medical Informatics Association.
Stephanie O. Zandieh, PhD, from the department of pediatrics at Weill Cornell Medical College in New York City, and colleagues sought to evaluate practitioners' expectations of, and satisfaction with, older and newer EHRs after a transition.
Pre- and post-transition surveys were administered at six academic-affiliated ambulatory care practices from 2006 to 2008. Four practices transitioned to one commercial EHR and two practices to another. The researchers compared respondents' expectations of, and satisfaction with, the newer EHR.
According to the authors, 523 subjects were eligible: 217 were available before transition and 306 after transition. One hundred and sixty-two pre-transition and 197 post-transition responses were received, yielding 75 percent and 64 percent response rates, respectively.
“Practitioners were more satisfied with the newer EHRs (64 percent) compared with the older (56 percent) and a small majority (58 percent) were satisfied with the transition,” the authors found adding that practitioners' satisfaction with the older EHRs for completing clinical tasks was high. “The newer EHRs exceeded practitioner expectations regarding remote access (61 percent vs. 74 percent).
“However, the newer EHRs did not meet practitioners' expectations regarding their ability to perform clinical tasks, or more globally, improve medication safety (81 percent vs. 61 percent), efficiency (70 percent vs. 44 percent) and quality of care (77 percent vs. 67 percent).”
Most practitioners had favorable opinions about EHRs and reported overall improved satisfaction with the newer EHRs. However, practitioners' high expectations of the newer EHRs were often unmet regarding facilitation of specific clinical tasks or for improving quality, safety and efficiency.
Zandieh and colleagues noted that their study had several limitations including that the responding practitioners were all associated with a large urban academic center thus limiting generalizability and that the study measured perceptions three months after implementation. “It is possible that a longer period of acclimation to the new EHR would have affected our results. Lastly, differences in our response rates among practice sites and practitioner training levels may have introduced an unknown bias.
“Our research suggests that high expectations before transition may be unrealized for practitioners transitioning between EHR systems, and that this may impact practitioner satisfaction after transition,” the researchers concluded. “Understanding the unique perspective of practitioners transitioning between systems can allow for the development of better transition practices, improved pre-transition expectation management, and the design of EHRs that better reflect practitioner needs and priorities.”
Stephanie O. Zandieh, PhD, from the department of pediatrics at Weill Cornell Medical College in New York City, and colleagues sought to evaluate practitioners' expectations of, and satisfaction with, older and newer EHRs after a transition.
Pre- and post-transition surveys were administered at six academic-affiliated ambulatory care practices from 2006 to 2008. Four practices transitioned to one commercial EHR and two practices to another. The researchers compared respondents' expectations of, and satisfaction with, the newer EHR.
According to the authors, 523 subjects were eligible: 217 were available before transition and 306 after transition. One hundred and sixty-two pre-transition and 197 post-transition responses were received, yielding 75 percent and 64 percent response rates, respectively.
“Practitioners were more satisfied with the newer EHRs (64 percent) compared with the older (56 percent) and a small majority (58 percent) were satisfied with the transition,” the authors found adding that practitioners' satisfaction with the older EHRs for completing clinical tasks was high. “The newer EHRs exceeded practitioner expectations regarding remote access (61 percent vs. 74 percent).
“However, the newer EHRs did not meet practitioners' expectations regarding their ability to perform clinical tasks, or more globally, improve medication safety (81 percent vs. 61 percent), efficiency (70 percent vs. 44 percent) and quality of care (77 percent vs. 67 percent).”
Most practitioners had favorable opinions about EHRs and reported overall improved satisfaction with the newer EHRs. However, practitioners' high expectations of the newer EHRs were often unmet regarding facilitation of specific clinical tasks or for improving quality, safety and efficiency.
Zandieh and colleagues noted that their study had several limitations including that the responding practitioners were all associated with a large urban academic center thus limiting generalizability and that the study measured perceptions three months after implementation. “It is possible that a longer period of acclimation to the new EHR would have affected our results. Lastly, differences in our response rates among practice sites and practitioner training levels may have introduced an unknown bias.
“Our research suggests that high expectations before transition may be unrealized for practitioners transitioning between EHR systems, and that this may impact practitioner satisfaction after transition,” the researchers concluded. “Understanding the unique perspective of practitioners transitioning between systems can allow for the development of better transition practices, improved pre-transition expectation management, and the design of EHRs that better reflect practitioner needs and priorities.”