Improving performance in medical practices through the extended use of electronic medical record systems: a survey of Canadian family physicians.

Louis Raymond,Marie-Claude Trudel,Guy Paré,Ana Ortiz De Guinea,Thomas Micheneau,Josianne Marsan,Placide Poba-Nzaou

doi:10.1186/s12911-015-0152-8

Abstract

BackgroundNumerous calls have been made for greater assimilation of information technology in healthcare organizations in general, and in primary care settings in particular. Considering the levels of IT investment and adoption in primary care medical practices, a deeper understanding is needed of the factors leading to greater performance outcomes from EMR systems in primary care. To address this issue, we developed and tested a research model centered on the concept of Extended EMR Use.MethodsAn online survey was conducted of 331 family physicians in Canadian private medical practices to empirically test seven research hypotheses using a component-based structural equation modeling approach.ResultsFive hypotheses were partially or fully supported by our data. Family physicians in our sample used 67% of the clinical and 41% of the communicational functionalities available in their EMR systems, compared to 90% of the administrative features. As expected, extended use was associated with significant improvements in perceived performance benefits. Interestingly, the benefits derived from system use were mainly tied to the clinical support provided by an EMR system. The extent to which physicians were using their EMR systems was influenced by two system design characteristics: functional coverage and ease of use. The more functionalities that are available in an EMR system and the easier they are to use, the greater the potential for exploration, assimilation and appropriation by family physicians.ConclusionsOur study has contributed to the extant literature by proposing a new concept: Extended EMR Use. In terms of its practical implications, our study reveals that family physicians must use as many of the capabilities supported by their EMR system as possible, especially those which support clinical tasks, if they are to maximize its performance benefits. To ensure extended use of their software, vendors must develop EMR systems that satisfy two important design characteristics: functional coverage and system ease of use.

Highlights

Numerous calls have been made for greater assimilation of information technology in healthcare organizations in general, and in primary care settings in particular
Component-based structural equation modeling (SEM) was used to validate our research model; Partial Least Squares (PLS) was employed because it is better suited to measurement models that include both exogenous and endogenous formative constructs [67].b As implemented in SmartPLS software [68], this approach was chosen for its robustness with regard to the distribution of residuals [69]c
By developing and empirically testing a research model around the concept of “Extended electronic medical records (EMR) Use,” this study has produced original and novel results that may eventually apply to other types of clinical information systems deployed in other settings

Summary

Introduction

Numerous calls have been made for greater assimilation of information technology in healthcare organizations in general, and in primary care settings in particular. Considering the levels of IT investment and adoption in primary care medical practices, a deeper understanding is needed of the factors leading to greater performance outcomes from EMR systems in primary care To address this issue, we developed and tested a research model centered on the concept of Extended EMR Use. The need for the study In the face of rapidly increasing healthcare costs, associated with an aging population and the concomitant rise in chronic illnesses [1], governments in developed countries such as the United Kingdom and Canada have felt obliged to improve the efficiency and effectiveness with which primary medical care is provided to their citizens. An EMR system is designed to support the needs of individual physicians who are directly caring for patients in their medical practicesa

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Results

Conclusion