Abstract
BackgroundThe use of electronic health records (EHRs) to support the organization and delivery of healthcare is evolving rapidly. However, little is known regarding potential variation in access to EHRs by provider type or care setting. This paper reports on observed variation in the perceptions of access to EHRs by a wide range of cancer care providers covering diverse cancer care settings in Ontario, Canada.MethodsPerspectives were sought regarding EHR access and health record completeness for cancer patients as part of an internet survey of 5663 cancer care providers and administrators in Ontario. Data were analyzed using a multilevel logistic regression model. Provider type, location of work, and access to computer or internet were included as covariates in the model.ResultsA total of 1997 of 5663 (35%) valid responses were collected. Focusing on data from cancer care providers (N = 1247), significant variation in EHR access and health record completeness was observed between provider types, location of work, and level of computer access. Providers who worked in community hospitals were half as likely as those who worked in teaching hospitals to have access to their patients' EHRs (OR 0.45 95% CI: 0.24–0.85, p < 0.05) and were six times less likely to have access to other organizations' EHRs (OR 0.15 95% CI: 0.02–1.00, p < 0.05). Compared to surgeons, nurses (OR 3.47 95% CI: 1.80–6.68, p < 0.05), radiation therapists/physicists (OR 7.86 95% CI: 2.54–25.34, p < 0.05), and other clinicians (OR 4.92 95% CI: 2.15–11.27, p < 0.05) were more likely to report good access to their organization's EHRs.ConclusionVariability in access across different provider groups, organization types, and geographic locations illustrates the fragmented nature of EHR adoption in the cancer system. Along with focusing on technological aspects of EHR adoption within organizations, it is essential that there is cross-organizational and cross-provider access to EHRs to ensure patient continuity of care, system efficiency, and high quality care.
Highlights
The use of electronic health records (EHRs) to support the organization and delivery of healthcare is evolving rapidly
The results indicate that it is possible for cancer care providers to have good access to EHRs internally, but at the same time have poor access externally
This study explored the perceptions of EHR access by a wide range of cancer care providers covering diverse cancer care settings
Summary
The use of electronic health records (EHRs) to support the organization and delivery of healthcare is evolving rapidly. This paper reports on observed variation in the perceptions of access to EHRs by a wide range of cancer care providers covering diverse cancer care settings in Ontario, Canada. The aim of this paper was to examine perceptions of access to electronic health records (EHRs) by different types of cancer care providers in a wide range of care settings. In the context of this research, Electronic Health Records (EHR) refer broadly to the use of health information technology (HIT), including patient health information and data, clinical decision support, results management and central data repositories, and order entry management technologies such as computerized physician order entry (CPOE), to support the organization and delivery of care [1,2,3]. It has been suggested that these systems increase efficiency, improve patient safety, and are associated with improved health benefits [1] and more efficient use of physician time [4]
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