Abstract
Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes. The proposed research model incorporates six variables in the reformulated DeLone and McLean information systems success model: system quality, information quality, service quality, use, user satisfaction and net benefits. Two variables training and self-efficacy were also incorporated into the model. A questionnaire survey instrument was designed to measure the eight variables in the model. After a pilot test, the measurement scale was used to collect data from 243 nursing staff members in 10 residential aged care homes belonging to three management groups in Australia. Partial least squares path modeling was conducted to validate the model. The validated EHR systems success model predicts the impact of the four antecedent variables—training, self-efficacy, system quality and information quality—on the net benefits, the indicator of EHR systems success, through the intermittent variables use and user satisfaction. A 24-item measurement scale was developed to quantitatively evaluate the performance of an EHR system. The parsimonious EHR systems success model and the measurement scale can be used to benchmark EHR systems success across organizations and units and over time.
Highlights
According to the International Organization for Standardization, electronic health records (EHR) are “repository of patient data in digital form, stored and exchanged securely, and accessible by multiple authorized users
Measuring the success of EHR in residential aged care had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript; RSL Care responded to the questionnaire; Uniting responded to the questionnaire; Warrigal Care responded to the questionnaire; Aged and Community Care Services Australia had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Similar to the national data [40], approximately 90% of the survey respondents were female. 46.1% of nursing staff members were under 40 years old. 31.7% were between the age of 40 to 60 years and only 5.3% were over 60 years old
Summary
According to the International Organization for Standardization, electronic health records (EHR) are “repository of patient data in digital form, stored and exchanged securely, and accessible by multiple authorized users. Measuring the success of EHR in residential aged care had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript (http://www.irt.org.au/); RSL Care responded to the questionnaire Rslcare.com.au/); Uniting responded to the questionnaire (https://uniting.org/); Warrigal Care responded to the questionnaire Warrigal.com.au/); Aged and Community Care Services Australia had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript Measuring the success of EHR in residential aged care had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript (http://www.irt.org.au/); RSL Care responded to the questionnaire (http://www. rslcare.com.au/); Uniting responded to the questionnaire (https://uniting.org/); Warrigal Care responded to the questionnaire (http://www. warrigal.com.au/); Aged and Community Care Services Australia had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript (http://www. agedcare.org.au/)
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