Electronic Medical Record Training Research Articles

Effects of an EMR Education Program on Nursing Information Literacy, Self-Directed Learning, Problem-Solving Ability, and Practice Satisfaction of Undergraduate Nursing Students

Purpose: This study implemented an electronic medical record (EMR) training program for nursing students and aimed to confirm its effectiveness.Methods: A non-equivalent control group pretest-posttest design was used. The participants were 42 sophomore nursing students enrolled in a fundamental nursing course (experimental group: n=21, control group n=21). The EMR training program consisted of 6 sessions, taught over 5 weeks. Data were collected between April 23 and July 14, 2023, and were analyzed using the <i>x</i><sup>2</sup> test, Fisher exact test, t-test, paired t-test, Wilcoxon signed-rank test, and Mann-Whitney U test with SPSS for Windows version 24.0.Results: Significant differences were shown between the experimental and control groups regarding self-directed learning ability (t=2.22, <i>p</i>=.032), problem-solving ability (t=2.34, <i>p</i>=.026), practice satisfaction (U=136.00, <i>p</i>=.016) and EMR competency (U=101.50, <i>p</i>=.001).Conclusion: The EMR training program effectively improved nursing students’ self-directed learning ability, problem-solving ability, practice satisfaction, and EMR competency. Therefore, developing and applying EMR-related content can enhance nursing student’s awareness of EMR systems is recommended.

“A friendly reminder” – Improving workflow and efficiency in a pulmonary fellows’ outpatient continuity clinic

BackgroundSeeing patients in an ambulatory clinic generates electronic medical record (EMR) inbox tasks. Little is known about the standard baseline message turnaround time to EMR inbox task completion and whether electronic reminders improve turnaround time. Objective1) Obtain baseline message type and mean message turnaround time (MTT) to EMR inbox task completion data, 2) Standardize EMR workflow education, 3) Disseminate bi-weekly electronic reminders to fellows in their continuity clinic and measure MTT. MethodsProspective, non-randomized, unblinded, cross-over pre- and post-intervention pilot study in an ambulatory pulmonary clinic at a large, urban, academic referral health system. Sixteen pulmonary and critical care fellows affiliated with the Indiana University School of Medicine Pulmonary and Critical Care Fellowship were divided equally into two groups, with the study period from October of 2021 to May of 2022, and were given bi-weekly calendar reminders in Microsoft Outlook with measurement of EMR messages and MTT. Results2554 messages were acknowledged with result notes (n = 1676, 59.16 %) being the most common. There was a 40 % decrease in overall MTT from the pre- to the post-intervention period (MTT = 33 days in pre-intervention period for whole cohort, MTT = 19 days in post-intervention period). ConclusionsMTT for EMR inbox tasks at a large, academic center with fellowship trainees is roughly 2.5 weeks. These findings should prompt other institutions to investigate their own trainees’ inbox handling habits and validates the benefit of EMR training and reminders on fellowship trainee's in-basket task turnaround time.

Student Access to Electronic Medical Records: Missing an Opportunity to Prepare Our Workforce.

The use of an electronic medical record (EMR) during a student's clinical placement is intricately linked with student learning and skill development necessary to become a competent healthcare professional. However, significant variation currently exists in student EMR access and use within healthcare. In this study, we bring to light evidence of this variability amongst medical, nursing, pharmacy, and allied health student placements, both in policy and in practice. We found some health districts lack student policies on EMR use, as well as prohibiting important tasks including record writing capabilities. There was also variation in exposure to EMR training. In order to provide healthcare students with optimal education that includes technological competency, we identify a need for changes to both policies and practices.

An Electronic Medical Record Pocket Guide for Incoming Internal Medicine Interns: Perceptions and Impact on Patient Information Gathering.

The transition from medical student to intern is associated with a significant increase in workloads and responsibilities. This includes using the electronic medical record (EMR), which can lead to challenges in information gathering and patient care; however, no formal residency interventions exist in the use of an EMR for information gathering, with most EMR training occurring in the clinical setting. The present study aimed to improve information gathering on patient care and enhance the confidence of Internal Medicine interns in information gathering. We performed a pre- and postprospective study in July 2021. All of the Internal Medicine interns at our community hospital were included. A pre- and postassessment to evaluate interns' confidence was distributed to participants during orientation week and at the end of the inpatient Internal Medicine rotation. A pre- and postconfidence assessment was collected at the beginning and end, respectively, of each intern's inpatient Internal Medicine rotation. Seventeen (85%) interns completed both the preassessment and postassessment. Use of an EMR guide led to a significant increase in completeness of patient information gathering (preassessment: 73.2% ± 18.4% vs post-EMR guide: 94.7% ± 7.4%, P < 0.001) and in intern confidence (P = 0.001). The use of an EMR guide was well received among Internal Medicine interns and led to increased completeness in patient information gathering. Residency programs may benefit from developing an EMR guide to improving the transition of interns during residency.

Willingness to use electronic medical record (EMR) system and its associated factors among health professionals working in Amhara region Private Hospitals 2021, Ethiopia.

Despite the high expectations of electronic medical records as a great prospect for improving performance in healthcare, the level of adoption and utilization, particularly in a developing country, is low. Knowing the willingness to use the electronic medical record system in the private hospital has an impact on the future implementation status and utilization of the electronic medical record in Ethiopia. However, there was no evidence of the status of the willingness to use electronic medical record systems in private hospitals in the Amhara region. This study aimed to assess the willingness to use electronic medical record Systems and its associated factors among health professionals working in Amhara Region Private Hospitals. A cross-sectional institutional study was performed among 406 health professionals selected using proportional allocation with a simple random sampling technique in Amhara region private hospitals by using self-administered structured questionnaires. The data were analyzed using SPSS version 20 software. Descriptive statistics and binary logistic regression were performed to estimate the crude and adjusted odds ratios with a 95% Confidence interval. Out of the 406 participants included in the analysis, 307 (75.6%) showed a willingness to use the electronic medical record system. About three hundred twelve (76.8%) health professionals had good knowledge of electronic medical record systems, and 257 (63.3%) had good computer skills in electronic medical record systems. Health professionals who had electronic medical record knowledge (AOR = 1.85, 95% CI (1.004-3.409)), EMR training (3.29, 95% CI (1.353-8.003)), technical support personnel (1.92, 95% CI (1.122-3.305)), supportive supervision (AOR = 1.97, 95% CI (1.072-3.628)), and computer skill on electronic medical record (1.77, 95% CI (1.002-3.148)) were significantly associated with the outcome variable. This finding shows a good proportion of willingness to use the electronic medical record system. The most significant factors associated with willingness to use the electronic medical record system were a lack of computer skills, computer training, and knowledge of the electronic medical record system.

User Satisfaction of Using Electronic Medical Record System and Its Associated Factors among Healthcare Professionals in Ethiopia: A Cross-Sectional Study

Electronic medical record (EMR) systems have become essential for the proper management of patients' information. Electronic medical record systems are on the rise in developing countries due to the need to ensure improved quality of healthcare. However, EMR systems can be ignored, if users are not satisfied with the implemented system. User dissatisfaction has been associated with the failure of EMR systems as a primary factor. There is also limited research done in the Ethiopian context on EMR user satisfaction at private hospitals. This study is aimed at assessing user satisfaction with electronic medical records and associated factors among health professionals working at private hospitals in Addis Ababa. Institution-based cross-sectional quantitative study was conducted among health professionals working at private hospitals in Addis Ababa, from March to April 2021. A self-administered questionnaire was used to collect the data. EpiData version 4.6 and Stata version 25 were used for data entry and analysis, respectively. Descriptive analyses were computed for the study variables. Bivariable and multivariable logistic regression analyses were carried out to assess the significance of independent variables on dependent variables. A total of 403 (95.33% response rate) participants completed all the questionnaires. More than half of 214 (53.10%) of the participants were satisfied with the EMR system. Factors associated with user satisfaction with electronic medical records were good computer literacy (AOR = 2.92, 95% CI: [1.16-7.37]), perceived information quality (AOR = 3.54, 95% CI: [1.55-8.11]), perceived service quality (AOR = 3.15, 95% CI: [1.58-6.28]), perceived system quality (AOR = 3.05, 95% CI: [1.32-7.05]), EMR training (AOR = 4.00, 95% CI: [1.76-9.03]), computer access (AOR = 3.17, 95% CI: [1.19-8.46]), and HMIS training (AOR = 2.05, 95% CI: [1.22-6.71]). In this study, health professionals' EMR satisfaction was moderate. The result showed that EMR training, computer literacy, computer access, perceived system quality, information quality, service quality, and HMIS training were associated with user satisfaction. Improving computer-related training, system quality, information quality, and service quality is an important intervention to improve the healthcare professional's satisfaction towards using electronic health record systems in Ethiopia.

Electronic Medical Record System Use and Determinants in Ethiopia: Systematic Review and Meta-Analysis

The strategic plan of the Ethiopian Ministry of Health recommends an electronic medical record (EMR) system to enhance health care delivery and streamline data systems. However, only a few exhaustive systematic reviews and meta-analyses have been conducted on the degree of EMR use in Ethiopia and the factors influencing success. This will emphasize the factors that make EMR effective and increase awareness of its widespread use among future implementers in Ethiopia. This study aims to determine the pooled estimate of EMR use and success determinants among health professionals in Ethiopia. We developed a protocol and searched PubMed, Web of Sciences, African Journals OnLine, Embase, MEDLINE, and Scopus to identify relevant studies. To assess the quality of each included study, we used the Joanna Briggs Institute quality assessment tool using 9 criteria. The applicable data were extracted using Microsoft Excel 2019, and the data were then analyzed using Stata software (version 11; StataCorp). The presence of total heterogeneity across included studies was calculated using the index of heterogeneity I2 statistics. The pooled size of EMR use was estimated using a random effect model with a 95% CI. After reviewing 11,026 research papers, 5 papers with a combined total of 2439 health workers were included in the evaluation and meta-analysis. The pooled estimate of EMR usage in Ethiopia was 51.85% (95% CI 37.14%-66.55%). The subgroup study found that the northern Ethiopian region had the greatest EMR utilization rate (58.75%) and that higher (54.99%) utilization was also seen in publications published after 2016. Age groups <30 years, access to an EMR manual, EMR-related training, and managerial support were identified factors associated with EMR use among health workers. The use of EMR systems in Ethiopia is relatively low. Belonging to a young age group, accessing an EMR manual, receiving EMR-related training, and managerial support were identified as factors associated with EMR use among health workers. As a result, to increase the use of EMRs by health care providers, it is essential to provide management support and an EMR training program and make the EMR manual accessible to health professionals.

A Prospective Intervention to Reduce Burnout Among Academic Radiologists

Few studies have examined what constitutes effective interventions to reduce burnout among radiologists. We compared self-reported burnout among academic medical center radiologists before and after a series of departmental initiatives intended to increase wellbeing and professional satisfaction. This Institutional Review Board-approved, prospective study took place 2017-2019 in a tertiary academic medical center. In pre- (2017) and post-intervention (2019) periods, we administered the previously-validated Stanford Physician Wellness Survey to faculty in our 11-division radiology department. Faculty rated their burnout level across 8 domains (professional fulfillment, emotional exhaustion, interpersonal disengagement, sleep difficulties, self-compassion, negative work impact on personal relations, organizational/personal values alignment, perceived quality of supervisory leadership). Between the two surveys, departmental initiatives focusing on culture, team building, work-life balance, and personal well-being were implemented (e.g., electronic medical record training, shorter work hours). Pre- and post-survey results were compared, using Whitney-Mann U test to calculate Z scores. Faculty members rated lower professional fulfillment (Z-3.04, p=0.002), higher emotional exhaustion (Z=2.52, p=0.012), increased sleep-related impairment (Z=2.38, p=0.012), and reduced organizational/personal values alignment (Z=-4.10, p<0.0001) between the two surveys. No significant differences were identified associated with interpersonal disengagement (Z=1.82, p=0.069), self-compassion (Z=1.39, p=0.164), negative impact of work on personal relationship (Z=0.89, p=0.372) and perceived supervisory leadership quality (Z=0.07, p=0.942). Despite numerous departmental initiatives intended to improve culture, workplace efficiency, work-life balance, and personal wellness, self-reported burnout was unchanged or worsened over time.Physician and employee wellness embedded into institutional culture maybe more effective than departmental improvement initiatives.

Performance, Barriers, and Satisfaction of Healthcare Workers Toward Electronic Medical Records in Saudi Arabia: A National Multicenter Study.

BackgroundElectronic medical record (EMR) systems are nowadays available internationally, including in Saudi Arabia. Nevertheless, there are still many obstacles to overcome before their effective implementation. This cross-national study aimed to investigate the perceptions and practices of healthcare workers toward implemented EMR systems.MethodsA cross-sectional study was conducted across selected hospitals in the four cities of Al-Ahsa, Dammam, Medina, and Riyadh in Saudi Arabia. Healthcare workers of all specialties were invited to participate in the study during the six-month study period from August 2019 to February 2020. The questionnaire was submitted online through institutional e-mails.ResultsThe study included a total of 2684 healthcare providers. Almost half of the respondents (47.1%) were aged between 35 and 50 years. High experience with computer use was observed among 38.3% of them, while 54.3% attended EMR training activities. The performance scores of EMR’s compared to previous routines had a median of 24 (interquartile range {IQR} = 0-38). The satisfaction scores with EMR’s ranged between 16 and 80 with a median of 53 (IQR = 48-61). Older participants (>50 years), non-Saudis, and those who attended EMR training had statistically significant higher scores of both EMR performance and EMR satisfaction, (p<0.001). Those working in other medical specialties (not major) had statistically significant higher scores of EMR performance alone (p<0.001), while general practitioners (p<0.001) and females (p = 0.001) had statistically significant higher scores of EMR satisfaction alone. EMR systems’ positive impact on quality of care was the highest agreed-upon benefit reported, while the temporary loss of access to patient records if computers crashed or power failed was the highest agreed-upon barrier.ConclusionsThe attitude and satisfaction of healthcare workers in Saudi Arabia towards EMR systems are acceptable particularly among those who are older, non-Saudi, and have attended EMR training. Improved quality of care was the main noted benefit of EMR’s, followed by improved productivity. The temporary loss of access to patient records if computers crashed or power failed, followed by privacy and security concerns, was the major EMR barrier mentioned.

Physicians' Attitude towards Electronic Medical Record Systems: An Input for Future Implementers.

Background Electronic medical record (EMR) systems offer the potential to improve health care quality by allowing physicians real-time access to patient healthcare information. The endorsement and usage of EMRs by physicians have a significant influence on other user groups in the healthcare system. As a result, the purpose of this study was to examine physicians' attitudes regarding EMRs and identify the elements that may influence their attitudes. Method An institutional-based cross-sectional study design supplemented with a qualitative study was conducted from March 1 to April 30, 2018, among a total of 403 physicians. A self-administered questionnaire was used to collect quantitative data. The validity of the prediction bounds for the dependent variable and the validity of the confidence intervals and P values for the parameters were measured with a value of less than 0.05 and 95 percent of confidence interval. For the supplementary qualitative study, data were collected using semistructured in-depth interviews from 11 key informants, and the data were analyzed using thematic analysis. Result Physicians' computer literacy (CI: 0.264, 0.713; P: 0001) and computer access at work (CI: 0.141, 0.533, P: 0.001) were shown to be favorable predictors of their attitude towards EMR system adoption. Another conclusion from this study was the inverse relationship between physicians' prior EMR experience and their attitude about the system (CI: -0.517, -0.121; P: 0.002). Conclusion According to the findings of this study, physicians' attitudes regarding EMR were found moderate in the studied region. There was a favorable relationship between computer ownership, computer literacy, lack of EMR experience, participation in EMR training, and attitude towards EMR. Improving the aforementioned elements is critical to improving physicians' attitudes regarding EMR.

Implementing a New EMR. How Should We Train the Staff?

Background Information Transitioning from an existing to a new Electronic Medical Record (EMR) while the surgical schedule of a busy perioperative department keeps running as usual can be daunting for nurses and other staff. While user training is part of the EMR implementation process, and crucial to ensure a smooth transition, its content might not be tailored to the role and responsibilities of the nurses involved. Feedback from perioperative nurses on the Virtual Live Training (VLT) provided by the EMR vendor, and its effectiveness to assist nurses documenting patient care on the new EMR, revealed that additional educational support was required. This project focused on the staff education initiative taken by designated unit EMR super-users to ensure Pre and Postoperative nurses’ readiness to document patient care in the new EMR by Go Live day. Objectives of Project • Identify and meet nurses’ learning needs related to the use of the new EMR after the VLT • Ensure training delivery method is effective for all perioperative areas • Ensure perioperative nurses’ readiness to document patient care independently on the new EMR • Ensure a smooth transition from existing to new EMR, while making sure patient care is not compromised Process of Implementation Developed EMR in-person training curriculum to support vendor's virtual live training. Created a training timeline based on goals. Prioritized super-users in-person training. Tailored in-person training sessions to the nurses’ role, pre and postoperative nurses training was conducted separately. Established training schedules, location and staffing. Developed an EMR resource digital folder. Build a Smart Sheet to capture documentation/workflow issues and view solutions. Use patient case scenarios to assess nurses’ competency documenting patient care from admission to discharge in new EMR. Statement of Successful Practice Increased nurses’ satisfaction with to face-to-face training. Postoperative nurses reported increased satisfaction with in-person class content being tailored to postop care. Improved nurses’ performance documenting most aspects of patient care in the new EMR. Improved understanding of new pre/postoperative workflows. Implication for Advancing the Practice of Perianesthesia Nursing Adjusting EMR training based on nurses’ feedback, tailoring training content to nurses’ role, and prioritizing super-user training, have proved to be effective training strategies to assist our perianesthesia nurses to ensure a successful EMR transition. Transitioning from an existing to a new Electronic Medical Record (EMR) while the surgical schedule of a busy perioperative department keeps running as usual can be daunting for nurses and other staff. While user training is part of the EMR implementation process, and crucial to ensure a smooth transition, its content might not be tailored to the role and responsibilities of the nurses involved. Feedback from perioperative nurses on the Virtual Live Training (VLT) provided by the EMR vendor, and its effectiveness to assist nurses documenting patient care on the new EMR, revealed that additional educational support was required. This project focused on the staff education initiative taken by designated unit EMR super-users to ensure Pre and Postoperative nurses’ readiness to document patient care in the new EMR by Go Live day. • Identify and meet nurses’ learning needs related to the use of the new EMR after the VLT • Ensure training delivery method is effective for all perioperative areas • Ensure perioperative nurses’ readiness to document patient care independently on the new EMR • Ensure a smooth transition from existing to new EMR, while making sure patient care is not compromised Developed EMR in-person training curriculum to support vendor's virtual live training. Created a training timeline based on goals. Prioritized super-users in-person training. Tailored in-person training sessions to the nurses’ role, pre and postoperative nurses training was conducted separately. Established training schedules, location and staffing. Developed an EMR resource digital folder. Build a Smart Sheet to capture documentation/workflow issues and view solutions. Use patient case scenarios to assess nurses’ competency documenting patient care from admission to discharge in new EMR. Increased nurses’ satisfaction with to face-to-face training. Postoperative nurses reported increased satisfaction with in-person class content being tailored to postop care. Improved nurses’ performance documenting most aspects of patient care in the new EMR. Improved understanding of new pre/postoperative workflows. Adjusting EMR training based on nurses’ feedback, tailoring training content to nurses’ role, and prioritizing super-user training, have proved to be effective training strategies to assist our perianesthesia nurses to ensure a successful EMR transition.

Using a Semi-Structured Qualitative Interview to Evaluate Pediatric Interns' Use of the Electronic Medical Record in a Simulated Setting.

IntroductionEffective use of electronic medical record (EMR) is paramount to delivering safe and effective care. Current EMR education is inadequate, with literature showing frequent deficiencies in skills needed to obtain and interpret data. This study aims to evaluate pediatric interns' perception of EMR inclusion in scenario-based simulation training.MethodsA total of 13 pediatric interns participated in an EMR-enhanced, multidisciplinary simulation of a pediatric patient with septic shock during the 2019-2020 academic year. Following the simulation, the interns participated in a semi-structured interview to evaluate the experience of having the EMR incorporated into the simulation and what benefits it offers.ResultsOf the 13 interns, 12 (92%) felt that incorporating the EMR into the simulation increased the realism of the scenario. All (100%) interns reported that EMR inclusion led to increased learning about the EMR, including gaining or re-learning skills needed to access or interpret electronic clinical data. Participants felt that EMR inclusion in the simulation provided valuable learning opportunities not present in traditional EMR education.ConclusionsIntegrating the EMR into simulation is viewed positively by pediatric interns, is perceived to improve simulation realism, and helps teach important EMR skills. EMR training would benefit from incorporation into scenario-based simulations.

Responding to the Challenge of a Pandemic: The Rapid Conversion of Electronic Medical Record Training for Nurses From Classroom-Based Instructional Learning to a Blended Learning Approach in a Large Multisite Organization.

Responding to the Challenge of a Pandemic: The Rapid Conversion of Electronic Medical Record Training for Nurses From Classroom-Based Instructional Learning to a Blended Learning Approach in a Large Multisite Organization.

Willingness to Use Electronic Medical Record (EMR) System in Healthcare Facilities of Bahir Dar City, Northwest Ethiopia.

Background Globally, electronic information and communication technology has been applied and much expanded in the healthcare industry. However, in developing counties including Ethiopia, EMR system adoption and utilization for medical practice are still inconsistent, and healthcare institutions which started utilization currently have also failed to sustain. A desirable readiness of healthcare experts is mandatory to expand digital health service delivery. Thus, this study is aimed at estimating the proportion of the willingness of professionals in Bahir Dar city to use EMR and at identifying factors associated with this proportion. Methods An institution-based cross-sectional study was conducted from September 1 to October 30, 2019, among 634 health professionals. Respondents were selected using a simple random sampling method. Data were entered into EpiData version 3.1 and exported to SPSS version 23 for further analysis. Descriptive statistics were computed to describe study variables and presented using tables. Willingness to use the EMR system was computed. Bivariable and multivariable binary logistic regression models were fitted to identify the associated factors. The odds ratio with 95% confidence interval was used to measure the strength of association. Results A total of 616 health professionals participated in the study with a response rate of 97%. The proportion of willingness to use the EMR system was 85.9%. Among health professionals who were not willing to use EMR, lack of access to EMR training (73.4%) was a major barrier to the willingness to use EMR. A multivariable logistic regression analysis showed that those health professionals who had good computer skill (AOR = 2.5; 95% CI: 1.3-4.6), good knowledge on EMR (AOR = 2.1; 95% CI: 1-4.4), gotten EMR training (AOR = 3.8; 95% CI: 1.7-8.1), EMR guideline access (AOR = 2.8; 95% CI: 1.4-5.6), and management support (AOR = 2.6; 95% CI: 1.4-4.8) were more likely willing to use the EMR system. Conclusions Majority of the professionals were willing to use the EMR system. EMR program should involve computer illiterate, less knowledgeable, those unable to access EMR guidelines, and managerially unsupported professionals. Enhancing health professionals' attitude and contextualizing EMR training in the healthcare curricula are highly recommended to scale up EMR use.

Family Connect: Keeping families informed during the COVID-19 pandemic

Family Connect programs to enhance communication with families and care partners who were unable to visit their inpatient loved ones during the COVID-19 crisis. While they differed in composition, the Family Connect programs at both institutions leveraged providers who had decreased clinical activity during the pandemic. The Family Connect team became integrated with the team. At both institutions, Family Connect teams perform virtual chart review, discuss patient status and care plan with the primary provider and communicate with the patient’s designated family member or care partner daily. Conversations are documented in the electronic medical record (EMR), which allows for metric tracking and clear communication to all team members. All Family Connect providers undergo a comprehensive training program focused on workflow, communication, and EMR training. Family Connect can be tailored to the needs of specific health systems based on patient volume and staffing. The NYULH Family Connect model incorporated medical student mentorship, on-site nurse liaisons to assist patients with virtual visits with families, and a 24/7 call center for family support. The YNHHS model was separate from the YNHHS COVID-19 call center and utilized attending and trainee physicians. The program is highly portable and can be easily reinitiated if needed.

Effective Design, Development, and Evaluation of Video Tutorials for Electronic Medical Record Training

Abstract Background Electronic medical record (EMR) use by primary care physicians (PCP) in the United States and Canada is suboptimal, especially for supporting chronic diseases like diabetes. PCPs need postimplementation training to achieve value-adding EMR use. Video tutorials demonstrate how to accomplish tasks using software. However, there is a dearth of research on the use of video tutorials for EMR training. Objective The purpose of the study was to design, develop, and evaluate video tutorials for training PCPs in using EMR advanced features for diabetes care. This study addressed three research questions related to PCP's views of video tutorials as an EMR training method/approach, barriers, and facilitators to applying the EMR video tutorials to PCPs' practice, and how the design of EMR video tutorials can be improved. Methods The overall research study employed a QUAN (qual) mixed methods approach with an embedded design. This article focuses on the qualitative phase of the mixed methods study. A series of four theory-informed and evidence-based video tutorials for diabetes care was developed with a physician champion. Qualitative data were collected at four time points: 1 month before (O1), immediately before (O2), 3 months after (O3), and 6 months (O4) after the intervention. Semistructured interviews with participants were held at O3 and O4. Qualitative data were analyzed using thematic analysis. Results In total, 14 PCPs from the overall study participated in interviews (78%). The thematic analysis of the qualitative data revealed seven themes, which fall into two main categories: (1) design and development of EMR video tutorials, and (2) adoption and use of EMR video tutorials. Conclusion PCPs liked the EMR video tutorials for diabetes care, and would like more EMR video tutorials on various topics and EMR use levels. The study offers a roadmap for health informatics professionals everywhere to develop EMR training videos that meet evidence-based design criteria. It also help to identify opportunities to improve the design, delivery, and adoption of EMR video tutorials for future training interventions.

Primary Care Physicians' Experience Using Advanced Electronic Medical Record Features to Support Chronic Disease Prevention and Management: Qualitative Study.

BackgroundChronic diseases are the leading cause of death worldwide. In Canada, more than half of all health care spending is used for managing chronic diseases. Although studies have shown that the use of advanced features of electronic medical record (EMR) systems improves the quality of chronic disease prevention and management (CDPM), a 2012 international survey found that Canadian physicians were the least likely to use 2 or more EMR system functions. Some studies show that maturity vis-à-vis clinicians’ EMR use is an important factor when evaluating the use of advanced features of health information systems. The Clinical Adoption Framework (CAF), a common evaluation framework used to assess the success of EMR adoption, does not incorporate the process of maturing. Nevertheless, the CAF and studies that discuss the barriers to and facilitators of the adoption of EMR systems can be the basis for exploring the use of advanced EMR features.ObjectiveThis study aimed to explore the factors that primary care physicians in Ontario identified as influencing their use of advanced EMR features to support CDPM and to extend the CAF to include primary care physicians’ perceptions of how their use of EMRs for performing clinical tasks has matured.MethodsGuided by the CAF, directed content analysis was used to explore the barriers and facilitating factors encountered by primary care physicians when using EMR features. Participants were primary care physicians in Ontario, Canada, who use EMRs. Data were coded using categories from the CAF.ResultsA total of 9 face-to-face interviews were conducted from January 2017 to July 2017. Dimensions from the CAF emerged from the data, and one new dimension was derived: physicians’ perception of their maturity of EMR use. Primary care physicians identified the following key factors that impacted their use of advanced EMR features: performance of EMR features, information quality of EMR features, training and technical support, user satisfaction, provider’s productivity, personal characteristics and roles, cost benefits of EMR features, EMR systems infrastructure, funding, and government leadership.ConclusionsThe CAF was extended to include physicians’ perceptions of how their use of EMR systems had matured. Most participants agreed that their use of EMR systems for performing clinical tasks had evolved since their adoption of the system and that certain system features facilitated their care for patients with chronic diseases. However, several barriers were identified and should be addressed to further enhance primary care physicians’ use of advanced EMR features to support CDPM.

Evaluating a post-implementation electronic medical record training intervention for diabetes management in primary care

ObjectiveThis study evaluated the potential for electronic medical record (EMR) video tutorials to improve diabetes (type 1 and 2) care processes by primary care physicians (PCP) using OSCAR EMR.DesignA QUAN(qual)...

An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses.

In recent times, policies stemming from the American Recovery and Reinvestment Act of 2009 have served as a stimulus for healthcare organizations to adopt an electronic medical record. As a result, nurses are now more knowledgeable of and experienced with an electronic medical record. In August 2016, our facility converted from instructor-led training to electronic learning for inpatient nurse electronic medical record training, hoping to capitalize on previous experience with the clinical information system. However, a complete program evaluation of this transition had yet to be conducted. The purpose of this study was to evaluate electronic learning usability and the return on investment of an electronic medical record training conversion. Evaluations of electronic medical record electronic learning training were collected from 75 newly hired, inpatient nurses from November and December 2017, and compared to our instructor-led program. Results showed that users found it effective and were satisfied with this training method. The electronic learning had superior efficiency, reducing training time by ~50% compared to instructor-led training, while proving to yield effectiveness and satisfaction. The return on investment was $18 540, with a gain of 593.25 hours in nursing time during the study period of two months. These results support the organizational decision to convert to electronic learning, further supporting the conversion for other clinical roles.

An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses.

An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses.