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Physician Use of Electronic Health Records: Survey Study Assessing Factors Associated With Provider Reported Satisfaction and Perceived Patient Impact.
JMIR Med Inform. 2019 Apr 04; 7(2):e10949.JM

Abstract

BACKGROUND

The effect electronic health record (EHR) implementation has on physician satisfaction and patient care remains unclear. A better understanding of physician perceptions of EHRs and factors that influence those perceptions is needed to improve the physician and patient experience when using EHRs.

OBJECTIVE

The objective of this study was to determine provider and clinical practice factors associated with physician EHR satisfaction and perception of patient impact.

METHODS

We surveyed a random sample of physicians, including residents and fellows, at a US quaternary care academic hospital from February to March 2016. The survey assessed provider demographics, clinical practice factors (ie, attending, fellow, or resident), and overall EHR experience. The primary outcomes assessed were provider satisfaction and provider perceptions of impact to patient care. Responses on the satisfaction and patient impact questions were recorded on a continuous scale initially anchored at neutral (scale range 0 to 100: 0 defined as "extremely negatively" and 100 as "extremely positively"). Independent variables assessed included demographic and clinical practice factors, including perceived efficiency in using the EHR. One-way analysis of variance or the Kruskal-Wallis test was used for bivariate comparisons, and linear regression was used for multivariable modeling.

RESULTS

Of 157 physicians, 111 (70.7%) completed the survey; 51.4% (57/111) of the respondents were attending physicians, and of those, 71.9% (41/57) reported a >50% clinical full-time-equivalency and half reported supervising residents >50% of the time. A total of 50.5% (56/111) of the respondents were primary care practitioners, previous EHR experience was evenly distributed, and 12.6% (14/111) of the total sample were EHR super-users. Responses to how our current EHR affects satisfaction were rated above the neutral survey anchor point (mean 58 [SD 22]), as were their perceptions as to how the EHR impacts the patient (mean 61 [SD 18]). In bivariate comparisons, only physician age, clinical role (resident, fellow, or attending), and perceived efficiency were associated with EHR satisfaction. In the linear regression models, physicians with higher reported perceived efficiency reported higher overall satisfaction and patient impact after controlling for other variables in the model.

CONCLUSIONS

Physician satisfaction with EHRs and their perception of its impact on clinical care were generally positive, but physician characteristics, greater age, and attending level were associated with worse EHR satisfaction. Perceived efficiency is the factor most associated with physician satisfaction with EHRs when controlling for other factors. Understanding physician perceptions of EHRs may allow targeting of technology resources to ensure efficiency and satisfaction with EHR system use during clinical care.

Authors+Show Affiliations

Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States.Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States.Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States.Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States.Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30946023

Citation

Williams, Daniel Clay, et al. "Physician Use of Electronic Health Records: Survey Study Assessing Factors Associated With Provider Reported Satisfaction and Perceived Patient Impact." JMIR Medical Informatics, vol. 7, no. 2, 2019, pp. e10949.
Williams DC, Warren RW, Ebeling M, et al. Physician Use of Electronic Health Records: Survey Study Assessing Factors Associated With Provider Reported Satisfaction and Perceived Patient Impact. JMIR medical informatics. 2019;7(2):e10949.
Williams, D. C., Warren, R. W., Ebeling, M., Andrews, A. L., & Teufel Ii, R. J. (2019). Physician Use of Electronic Health Records: Survey Study Assessing Factors Associated With Provider Reported Satisfaction and Perceived Patient Impact. JMIR Medical Informatics, 7(2), e10949. https://doi.org/10.2196/10949
Williams DC, et al. Physician Use of Electronic Health Records: Survey Study Assessing Factors Associated With Provider Reported Satisfaction and Perceived Patient Impact. JMIR medical informatics. 2019 Apr 4;7(2):e10949. PubMed PMID: 30946023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physician Use of Electronic Health Records: Survey Study Assessing Factors Associated With Provider Reported Satisfaction and Perceived Patient Impact. AU - Williams,Daniel Clay, AU - Warren,Robert W, AU - Ebeling,Myla, AU - Andrews,Annie L, AU - Teufel Ii,Ronald J, Y1 - 2019/04/04/ PY - 2018/05/02/received PY - 2018/12/31/accepted PY - 2018/12/10/revised PY - 2019/4/5/entrez PY - 2019/4/5/pubmed PY - 2019/4/5/medline KW - efficiency KW - electronic health records KW - physician survey KW - user satisfaction SP - e10949 EP - e10949 JF - JMIR medical informatics VL - 7 IS - 2 N2 - BACKGROUND: The effect electronic health record (EHR) implementation has on physician satisfaction and patient care remains unclear. A better understanding of physician perceptions of EHRs and factors that influence those perceptions is needed to improve the physician and patient experience when using EHRs. OBJECTIVE: The objective of this study was to determine provider and clinical practice factors associated with physician EHR satisfaction and perception of patient impact. METHODS: We surveyed a random sample of physicians, including residents and fellows, at a US quaternary care academic hospital from February to March 2016. The survey assessed provider demographics, clinical practice factors (ie, attending, fellow, or resident), and overall EHR experience. The primary outcomes assessed were provider satisfaction and provider perceptions of impact to patient care. Responses on the satisfaction and patient impact questions were recorded on a continuous scale initially anchored at neutral (scale range 0 to 100: 0 defined as "extremely negatively" and 100 as "extremely positively"). Independent variables assessed included demographic and clinical practice factors, including perceived efficiency in using the EHR. One-way analysis of variance or the Kruskal-Wallis test was used for bivariate comparisons, and linear regression was used for multivariable modeling. RESULTS: Of 157 physicians, 111 (70.7%) completed the survey; 51.4% (57/111) of the respondents were attending physicians, and of those, 71.9% (41/57) reported a >50% clinical full-time-equivalency and half reported supervising residents >50% of the time. A total of 50.5% (56/111) of the respondents were primary care practitioners, previous EHR experience was evenly distributed, and 12.6% (14/111) of the total sample were EHR super-users. Responses to how our current EHR affects satisfaction were rated above the neutral survey anchor point (mean 58 [SD 22]), as were their perceptions as to how the EHR impacts the patient (mean 61 [SD 18]). In bivariate comparisons, only physician age, clinical role (resident, fellow, or attending), and perceived efficiency were associated with EHR satisfaction. In the linear regression models, physicians with higher reported perceived efficiency reported higher overall satisfaction and patient impact after controlling for other variables in the model. CONCLUSIONS: Physician satisfaction with EHRs and their perception of its impact on clinical care were generally positive, but physician characteristics, greater age, and attending level were associated with worse EHR satisfaction. Perceived efficiency is the factor most associated with physician satisfaction with EHRs when controlling for other factors. Understanding physician perceptions of EHRs may allow targeting of technology resources to ensure efficiency and satisfaction with EHR system use during clinical care. SN - 2291-9694 UR - https://www.unboundmedicine.com/medline/citation/30946023/Physician_Use_of_Electronic_Health_Records:_Survey_Study_Assessing_Factors_Associated_With_Provider_Reported_Satisfaction_and_Perceived_Patient_Impact_ L2 - https://medinform.jmir.org/2019/2/e10949/ DB - PRIME DP - Unbound Medicine ER -
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