Advanced EMR functionalities and Frontline Staff’s Perception of Clinical Proces Integration

Abstract

Electronic Medical Records (EMR) is considered to facilitate care integration, as EMRs can enable information flow and care coordination. Yet, evidence also suggests negative consequences such as increased provider burden. Research has yet to identify whether and in what way EMRs can promote care integration. This research studied the association between EMR functionalities, designed to enhance the alignment and exchange of clinical information across health care facilities, and clinical process integration within and outside health systems as perceived by staff of health system affiliated primary care practices. Using survey methods, we collected data from 700 primary care staff members in 48 practice sites within 18 physician organizations affiliated with 13 health systems. To examine associations between EMR functionalities and perceived care integration, we used multi-level linear regression models, weighting staff survey data for differences in response rate by discipline. Among distinguishing EMR functionalities, clinical decision support (?=0.23, p=0.02), medication management (?=0.22, p=0.04), and electronic messaging (?=0.32, p<0.01) were significantly associated with higher levels of perceived clinical process integration within health system, but not outside the system. Our findings provide guidance to health systems in efforts to improve clinical process integration.