Use of electronic medical records and quality of patient data: different reaction patterns of doctors and nurses to the hospital organization

Ferry Koster,Mattijs S. Lambooij,Hanneke W. Drewes

doi:10.1186/s12911-017-0412-x

Abstract

BackgroundAs the implementation of Electronic Medical Records (EMRs) in hospitals may be challenged by different responses of different user groups, this paper examines the differences between doctors and nurses in their response to the implementation and use of EMRs in their hospital and how this affects the perceived quality of the data in EMRs.MethodsQuestionnaire data of 402 doctors and 512 nurses who had experience with the implementation and the use of EMRs in hospitals was analysed with Multi group Structural equation modelling (SEM). The models included measures of organisational factors, results of the implementation (ease of use and alignment of EMR with daily routine), perceived added value, timeliness of use and perceived quality of patient data.ResultsDoctors and nurses differ in their response to the organisational factors (support of IT, HR and administrative departments) considering the success of the implementation. Nurses respond to culture while doctors do not. Doctors and nurses agree that an EMR that is easier to work with and better aligned with their work has more added value, but for the doctors this is more pronounced. The doctors and nurses perceive that the quality of the patient data is better when EMRs are easier to use and better aligned with their daily routine.ConclusionsThe result of the implementation, in terms of ease of use and alignment with work, seems to affect the perceived quality of patient data more strongly than timeliness of entering patient data. Doctors and nurses value bottom-up communication and support of the IT department for the result of the implementation, and nurses respond to an open and innovative organisational culture.

Highlights

As the implementation of Electronic Medical Records (EMRs) in hospitals may be challenged by different responses of different user groups, this paper examines the differences between doctors and nurses in their response to the implementation and use of Electronic medical record (EMR) in their hospital and how this affects the perceived quality of the data in EMRs
Sample characteristics are shown in Table 1. 17% of the nurses reported to work in an academic hospital, 22% in a top-clinical hospital, 50% in a general hospital, 3% in a specialized hospital, 7% in a mental hospital, and 1% in a private hospital
In the Netherlands, there are 85 hospitals, 8 of which are academic hospitals (9.4%), and 90.6% are general or specialized hospitals.1. This means that in our respondent group, nurses and doctors from academic hospitals are overrepresented. This can be explained by the fact that we intended to include only nurses and doctors who had experience with working with EMR and that

Summary

Introduction

As the implementation of Electronic Medical Records (EMRs) in hospitals may be challenged by different responses of different user groups, this paper examines the differences between doctors and nurses in their response to the implementation and use of EMRs in their hospital and how this affects the perceived quality of the data in EMRs. For implementation processes to be successful and to prevent adverse effects it is essential that one considers the interaction between all user groups, the organisation and the innovation. Taking account of potential differences in responses between the user groups increases the chance of a successful implementation of EMRs [18, 19]. We build on the knowledge that the environment in which the innovation is adopted is essential for realisation of its potential [20]. A new element of our study is that we investigate differences in responses to the EMRs between two user groups, doctors and nurses

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