Use Of Electronic Medical Record Research Articles

Digital health in Latin America: current legislation and ethical aspectsSaúde digital na América Latina: legislação atual e aspectos éticos

Describe the current legislation on electronic medical records (EMR) and telehealth in Latin American countries and analyze the treatment of confidentiality and professional secrecy. Between March and September 2022, a survey of the regulations in force in 21 Latin American countries was conducted at two levels: the existence of legislation on EMR and telehealth, and the treatment of confidentiality and professional secrecy in EMR and telehealth. A data extraction form was prepared for each country. Data were collected from official on-line sources. The information was analyzed qualitatively and synthesized in tables when possible. The use of EMR is legally regulated in 16 countries. Nineteen countries have legislation on telehealth. All the countries analyzed safeguard confidentiality and professional secrecy through regulations. However, confidentiality and professional secrecy are mentioned in 11 countries in the context of telehealth, and in only nine countries in the context of EMR. Since the start of this century, Latin America has made progress in the legislation of digital tools for health care, such as EMR and telehealth. There is also interest in ethical issues related to the use of EMR and telehealth, particularly confidentiality and professional secrecy, aspects that should be strengthened in digital health.

Primary Care Physician Preferences Regarding Communication from Orthopaedic Surgeons.

Musculoskeletal consultations constitute a growing portion of primary care physician (PCP) referrals. Optimizing communication between PCPs and orthopaedists can potentially reduce time spent in the electronic medical record (EMR) as well as physician burnout. Little is known about the preferences of PCPs regarding communication from orthopaedic surgeons. Hence, the present study investigated, across a large health network, the preferences of PCPs regarding communication from orthopaedists. A total of 175 PCPs across 15 practices within our health network were surveyed. These providers universally utilized Epic as their EMR platform. Five-point, labeled Likert scales were utilized to assess the PCP-perceived importance of communication from orthopaedists in specific clinical scenarios. PCPs were further asked to report their preferred method of communication in each scenario and their overall interest in communication from orthopaedists. Logistic regression analyses were performed to determine whether any PCP characteristics were associated with the preferred method of communication and the overall PCP interest in communication from orthopaedists. A total of 107 PCPs (61.1%) responded to the survey. PCPs most commonly rated communication from orthopaedists as highly important in the scenario of an orthopaedist needing information from the PCP. In this scenario, PCPs preferred to receive an Epic Staff Message. Scenarios involving a recommendation for surgery, hospitalization, or a major clinical change were also rated as highly important. In these scenarios, an Epic CC'd Chart rather than a Staff Message was preferred. Increased after-hours EMR use was associated with diminished odds of having a high interest in communication from orthopaedists (odds ratio, 0.65; 95% confidence interval, 0.48 to 0.88; p = 0.005). Ninety-three PCPs (86.9%) reported spending 1 to 1.5 hours or more per day in Epic after normal clinical hours, and 27 (25.2%) spent >3 hours per day. Forty-six PCPs (43.0%) reported experiencing ≥1 symptom of burnout. There were distinct preferences among PCPs regarding clinical communication from orthopaedic surgeons. There was also evidence of substantial burnout and after-hours work effort by PCPs. These results may help to optimize communication between PCPs and orthopaedists while reducing the amount of time that PCPs spend in the EMR.

Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis of Hemodialysis Electronic Health Record Implementation.

The Nephrology Department of Hassan II Hospital in Fez, Morocco, has implemented an Electronic Medical Record (EMR) system for managing patients undergoing acute hemodialysis. This initiative aims to digitize patient monitoring and enhance the management of acute dialysis within the department. Conducting strengths, weaknesses, opportunities, and threats (SWOT) analysis - assessing strengths, weaknesses, opportunities, and threats - was crucial to identifying and understanding the internal strengths and weaknesses, as well as the external opportunities and threats. This article outlines the SWOT analysis findings that may impact the project's success and shape decision-making. It also discusses strategies that could be implemented to allocate resources, mitigate risks, and capitalize on potential advantages. This study involved a multidisciplinary team, including professors, nephrologists, nephrology residents, and a healthcare information system engineer. Brainstorming sessions were held during the specification drafting phase to pinpoint both internal and external factors affecting the project. User feedback during testing further refined these factors, ensuring the project's alignment with real-world needs and challenges. The study identifies the project's strengths as providing safe and immediate access to information, along with strong communication between the department (application users) and the project manager. The significant EMR weakness is the lack of logistical resources and the absence of a long-term maintenance plan for the application. The opportunity presented by this EMR implementation is its functionality's potential to evolve, enabling the solution to be deployed in other dialysis centers across the region. The project's threat is the potential abandonment of EMR use by future practitioners. These SWOT analysis findings enable the development and implementation of strategies to reduce the current deployment's vulnerabilities and ensure the success of future HIS implementations in the nephrology network of the Fez-Meknes region, Morocco.

Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study.

Tanzania has shown some improvements in the adoption of electronic medical record (EMR) systems in public health facilities; however, the rate of utilization of data generated from EMRs among health managers is not well documented. This study aims to assess the use of electronic medical record systems data in decision-making among health managers at public primary health facilities in Dodoma Region, Central Tanzania. A facility-based quantitative cross-sectional analytical study was conducted among 308 randomly selected health managers. A self-administered questionnaire supplemented with documentary review was used. Descriptive summary statistics and bivariable and multivariable logistic regression analyses (crude and adjusted odds ratios) were used. A P-value of <0.05 was used to declare statistically significant associations. Overall, more than a third (40.6%) of the health managers, that is 174 of the 308 included in the study, reported using data generated by EMR systems in decision-making. One-third (33.4%) of the health managers were adequately using data generated by EMR systems, of which 39.3% used data to support continuous quality improvement initiatives. Among the facilities visited, only nine (30%) had good documented EMR systems data use. Access to computers [adjusted odds ratio (AOR) = 4.72, 95% confidence interval (CI): 1.65, 13.48, p-value (p) = 0.004] and discussions on EMRs during meetings (AOR = 2.77, 95% CI: 1.01, 7.58, p = 0.047) were independent predictors of EMR system data use. Those who reported having EMR systems in all working areas were seven times more likely to use EMR system data (AOR = 7.23, 95% CI: 3.15, 16.59, p = 0.001). The respondents with good perceived EMR system information quality were more likely to use EMR system data (AOR = 2.84, 95% CI: 1.50, 5.39, p = 0.001) than those with poor perception. Furthermore, health managers who had excellent knowledge of computers and data use had higher odds of using EMR system data (AOR = 1.84, 95% CI: 3.38, 10.13, p = 0.001) compared with their counterparts. The findings of this study indicate that utilization of EMR system data in decision-making among health managers was optimal. It was found that training in itself is insufficient to improve use of EMR, which points to more organizational aspects of work routine as a challenge. Hence, a comprehensive approach that addresses these factors is essential for maximizing EMR system data use in decision-making.

The use of Electronic Medical Record (EMR) in hospitals during the COVID-19 pandemic in Indonesia: a systematic literature review

Purpose: Electronic medical records (EMR) are information technology-based systems that store and manage patient medical data. EMR are beneficial for improving healthcare services' efficiency, effectiveness, and security. The COVID-19 pandemic has driven the adoption of EMR, but there are still challenges, such as the surge in patient numbers and problems with EMR filling. This study aimed to investigate the use of EMR in hospitals during the COVID-19 pandemic in Indonesia. &#x0D; Method: This study was a systematic literature review using the PRISMA diagram. Article search was conducted based on the PICO model eligibility criteria. The articles used were retrieved from 3 databases: Google Scholar, ResearchGate, and Cerdika. The researcher limited the publication year of the journals to 2020-2021, when the COVID-19 pandemic was ongoing, and added the keyword "COVID-19" to the journals published in 2022-2023. &#x0D; Results: The results of the study showed that the COVID-19 pandemic has had a significant impact and the need for the implementation of EMR due to its various benefits, such as improving the efficiency and effectiveness of healthcare services, facilitating access to patient health information, increasing collaboration among healthcare workers, accelerating the process of clinical decision-making, and improving the security and accuracy of health data. However, implementing EMR during the COVID-19 pandemic has only sometimes been smooth. Some challenges include suboptimal infrastructure, untrained human resources, and inadequate policies. &#x0D; Conclusion: To overcome these challenges, efforts from various parties, including the government, hospitals, and healthcare workers, are needed.

Interrelationship among Personal Characteristics, Perceptions, and Self-Efficacy on Electronic Medical Record System (ERNRS) Use among Health Professionals

Improvements in the quality and safety of patient treatment are enhanced with the use of electronic medical records (EMRs). Despite the use of EMR, no established data existed on perceptions and self-efficacy and their relationship at the local level. The study assessed the interrelationships among personal characteristics, perceptions, and self-efficacy on EMR system use among 306 health professionals of a tertiary private hospital in Pasig, Metro Manila, Philippines, for the second quarter of 2023 who were chosen utilizing a proportionate stratified random sampling. This quantitative research used the descriptive, correlational design. Findings revealed that most respondents were young adults, females, had bachelor's degrees, had good typing ability, and had training in EMR systems. Most belonged to the medical department, used the system moderately, and served for 1-3 years. Overall, perceptions of EMR and self-efficacy were good. All the personal characteristics had a relationship with perceptions of EMR. All personal characteristics, except gender, were correlated with self-efficacy. However, gender was not. Lastly, perceptions of EMR had a relationship with self-efficacy. To address the findings, an action plan for telehealth utilization was created. In conclusion, perceptions of EMR and self-efficacy are influenced by personal characteristics, while perceptions of EMR influence self-efficacy.

Optimizing Nutrition Care Management at Nutrition Care Center (NCC)

In nutrition care services, the creation and storage of medical records at the Nutrition Care Center (NCC) are still relatively simple and paper-based or manual. Additionally, management challenges, in the form of system constraints, are one of the obstacles to healthcare management at NCC. Therefore, there is a need for optimizing healthcare management at NCC. The aim of this study is to optimize nutrition care management at the NCC clinic through the use of EMR (Electronic Medical Records) facilitated by QR Codes and the implementation of a Whatsapp Bot. The results indicate that optimizing Nutrition Care Management through the Implementation of EMR with QR Codes and Whatsapp Bot simplifies nutritionists' access to previous client allergy and therapy history in one view and facilitates clients in accessing their medical record number without a physical card. This research has also designed a system that can be used both through web and mobile platforms

Using Emr In A Corporate Hospital: Healthcare Providers Perspective From Bangladesh

Background: An Electronic Medical Record (EMR) is an essential tool for delivering high-quality healthcare in a hospital. In recent years, hospitals have increased their investment in EMRs to improve the level of integrated management of information. The purpose of this study was to explore the perspectives of using EMR among healthcare providers (HCPs) in a corporate hospital in Bangladesh.&#x0D; Methods: This cross-sectional study was conducted among 153 HCPs (doctors, nurses, lab technicians, drug dispensers, billing managers, and administrative personnel) who have access to EMR and working in a selected corporate hospital of Dhaka city. The study period was January to December 2019. HCPs were selected by convenience sampling technique. Data were collected by face-to-face interview using semi structured questionnaire. Data analysis was done by IBM SPSS software. Ethical issues were maintained strictly.&#x0D; Result: Study revealed that 59.5% HCPs were in the age group of 18-29 years with the mean age being 29.26 (±7.58) years. Only 32.7% HCPs had previous experience of using this type of software before working in the current hospital and 62.7% got technical training on EMR within the current hospital. The majority (81.7%) of the HCPs found that the technical training was effective for using the EMR software. The difficulty of using EMR was significantly associated with the age (p&lt;0.001), gender (p&lt;0.001), professional status (p&lt;0.001) and highest level of education (p&lt;0.001) of the HCPs. HCPs ability to overcome job related challenges was significantly associated with the professional status of them (p&lt;0.001). HCPs perception regarding effectiveness of EMR was found significantly associated with their place of technical training (p=0.004) and duration of the training (p=0.012).&#x0D; Conclusion: EMR can be a helpful tool for the health service providers to provider health services at the corporate hospitals. Digital literacy need to be increased among the HCPs to ensure effective use of EMRs. Regular maintenance and upgrades of the technology infrastructure are necessary for advanced record-keeping and quality service.&#x0D; JOPSOM 2021; 41(2):12-19

Investigating allied health professionals' attitudes, perceptions and acceptance of an electronic medical record using the Unified Theory of Acceptance and Use of Technology.

Objective This study aimed to investigate allied health professionals' (AHPs') perspectives pre- and post-implementation of an electronic medical record (EMR) in a tertiary health service in Australia and examine factors influencing user acceptance. Methods Data were collected pre- and post-EMR implementation via cross-sectional online surveys based on the Unified Theory of Acceptance and Usage of Technology (UTAUT). All AHPs at a large tertiary hospital were invited to complete the surveys. Data analysis included descriptive analysis, Mann-Whitney U tests for pre-post item- and construct-level comparison and content analysis of free-text responses. The theoretical model was empirically tested using partial least squares structural equation modelling. Results AHPs had positive attitudes toward EMR use both pre- and post-implementation. Compared to pre-implementation, AHPs felt more positive post-implementation about system ease of use and demonstrated decreased anxiety and apprehension regarding EMR use. AHPs felt they had adequate resources and knowledge to use EMR and reported real-time data accessibility as a main advantage. Disadvantages of EMR included an unfriendly user interface, system outages and decreased efficiency. Conclusions As AHPs increase EMR system familiarity, their positivity towards its use increases. An understanding of what influences AHPs when implementing new compulsory technology can inform change management strategies to improve adoption.

Use of Electronic Medical Records (EMR) in Gerontology: Benefits, Considerations and a Promising Future.

Electronic medical records (EMRs) have many benefits in clinical research in gerontology, enabling data analysis, development of prognostic tools and disease risk prediction. EMRs also offer a range of advantages in clinical practice, such as comprehensive medical records, streamlined communication with healthcare providers, remote data access, and rapid retrieval of test results, ultimately leading to increased efficiency, enhanced patient safety, and improved quality of care in gerontology, which includes benefits like reduced medication use and better patient history taking and physical examination assessments. The use of artificial intelligence (AI) and machine learning (ML) approaches on EMRs can further improve disease diagnosis, symptom classification, and support clinical decision-making. However, there are also challenges related to data quality, data entry errors, as well as the ethics and safety of using AI in healthcare. This article discusses the future of EMRs in gerontology and the application of AI and ML in clinical research. Ethical and legal issues surrounding data sharing and the need for healthcare professionals to critically evaluate and integrate these technologies are also emphasized. The article concludes by discussing the challenges related to the use of EMRs in research as well as in their primary intended use, the daily clinical practice.

Implementation of Electronic Medical Records at Primary Care in Semarang City Region: An Analysis of Individual and Organisational Determinants

Implementing electronic medical records (EMR) in Puskesmas faces various challenges and barriers that hinder system users. This study aims to identify the effects of individual and organizational factors on the implementation of EMR in Puskesmas located in Semarang City. The study was designed as a cross-sectional study and was conducted between August and September 2023. Participants were selected from five health centres representing five regions of Semarang city, and included 46 health professionals, including physicians, nurses, midwives, medical record keepers and IT staff. The survey was taken from a standardized questionnaire based on the Technology Acceptance Theory and Institutional Theory. The results showed that 34% of the respondents were between 20 and 30 years old, where 76.1% were female and 52.2% had a bachelor's degree, and were dominated by nurses, where the majority had 1-5 years of experience. The constant (a) of 1.770 indicates the value of the independent variables in increasing EMR usage. The regression coefficient of the individual factor variable of 0.207 has a positive effect on EMR implementation. Organisational factors negatively affect the implementation of EMR use. The test results found that individual factors partially and significantly (0.005 &lt;0.05) affect the implementation of EMR utilised.

Readiness of Medical Recording and Health Information Education Institutions in the Digital Transformation Era of UTAUT Based

Based on the results of the 2022 PERSI survey, Electronic Medical Records (EMR) ownership is not yet optimal. Permenkes Number 24 of 2022 concerning Medical Records, one of which mandates that EMR be mandatory in all hospitals in Indonesia. The Ministry of Health has a target in December 2023 to have completed the integration of One Health in all hospitals in Indonesia. Hospitals throughout Indonesia must race in the development of EMR according to the target of the Indonesian Ministry of Health. The aim to assist government programs by increasing knowledge of medical records and health information officers (PMIK) regarding the challenges and strategies of health education institutions in preparing graduates in the era of digital transformation of UTAUT-based health information. The method used is through an online national seminar with several speakers and attended by ≥ 570 participants. The results are achievement of increasing the enthusiasm of participants in increasing their knowledge with indicators of success obtaining post-test scores that are dominated by correct answers, interactive question, and answer discussions. The conclusion seminar activity can help government programs in increasing digital acceleration in Health Facilities, this can be continued in further research programs on evaluating the use of EMR.

Students’ perception of incorporating an electronic medical record in simulation

BackgroundUtilizing an electronic medical record (EMR) is a necessary competency that nursing students must possess. However, schools of nursing underutilize EMR in nursing curricula due to financial barriers of purchasing a system. PurposeThis quality improvement project aimed to collaborate with a medical center to create a fully functioning playground version of EMR at no cost to the students and evaluate student perception on the use of EMR during simulation education. MethodFaculty were trained on how to use the EMR system for simulation. Undergraduate nursing students (n=105) were surveyed at the end of the semester regarding their perception of the EMR experience and barriers faced. ResultsStudents were in favor of using an EMR in simulation to improve patient safety, enhance realism of the experience, and it was relatable to clinical practice. ConclusionThe findings of this quality improvement project support the use of EMR in simulation.

Development of an electronic medical records project for Al-Razi hospital in Palestine.

Electronic medical records (EMR) are considered an important aspect to improve medical services provided to patients. The purpose of this study was to assess the development of an Electronic Medical Records Project for Al-Razi hospital in Palestine. The study was mixed method, qualitative and quantitative. The use of a questionnaire for the staff in the Al-Razi hospital and seven administrators' participants were meat as focus group. Approximately 136 participants in the study. The study findings reported that employees perceived the use of EMRs to have several benefits. The most common benefits include promoting patient safety culture and drug error reduction. In addition, the study findings reported that employees perceived the use of EMRs to have several challenges. The most common challenges include lack of knowledge and skill, insufficient time to use EMR, and limited of computers. Health informatics brings various benefits to the healthcare system. Some participants believed that the EMR system would improve patient care and it will improve patient satisfaction.

Primary Care Physicians’ Preferences Regarding Communication from Orthopaedic Providers

Category: Other Introduction/Purpose: Musculoskeletal consultations constitute a growing portion of primary care physician (PCP) referrals. Optimization of communication between PCPs and orthopaedists can potentially reduce the time PCPs spend in the electronic medical record (EMR). This, in turn, may help reduce burnout. However, little is known about the preferences of PCPs regarding communication from orthopaedic specialists. The current study therefore investigated the preferences of PCPs across a large health network regarding communication from orthopaedists. Methods: One hundred and seventy-five PCPs across 15 practices within our health network were surveyed. These providers universally used the Epic Systems EMR. PCPs were asked to report their years in practice, panel size, typical number of electronic clinical messages received each day, time spent in the EMR after normal clinical hours, and burnout level. Likert scales and top-box scores were used to assess the PCPs’ perceived importance of communication from orthopedists in specific clinical scenarios. PCPs were further asked to report their preferred method of communication in each scenario and overall interest in communication from orthopaedists. Regression analyses were performed to determine if any PCP characteristics are associated with communication preferences and overall PCP interest in communication from orthopaedists. Results: A total of 107 (61%) PCPs completed the survey. PCPs most commonly rated communication from orthopaedists as highly important when the orthopaedist needed information from the PCP. In this scenario, PCPs preferred to receive an Epic Staff Message. Other scenarios rated as important included: the decision for surgery, hospitalization, and a major clinical change. In these scenarios, a CC’d Chart rather than Staff Message was preferred. Increased EMR use after-hours was associated with diminished odds of having high interest in communication from orthopaedists (odds ratio=0.65, 95% confidence interval: 0.48-0.88, P=0.005). Ninety-three PCPs (86.9%) reported spending at least 1 hour a day in Epic after normal clinical hours. Twenty-seven (25.2%) spent more than 3 hours. Forty-six PCPs (42.9%) reported experiencing at least one symptom of burnout. Conclusion: In the current study, there were distinct preferences among PCPs regarding clinical communication from orthopaedic surgeons. In addition, there was evidence of substantial burnout and after-hours work effort by PCPs. Our results may be helpful in optimizing communication between PCPs and orthopaedists, while also reducing time spent in the EMR by PCPs.

Benefits and challenges of adopting Electronic Medical Records in Nigerian Federal Capital Territory Hospitals-lessons learned

Electronic Medical Records (EMR) is a digital version of paper-based medical records designed to enhance patient outcomes. EMR in the healthcare system is fundamental to the continuity of patient care and the improvement of quality services. However, the lack of adequate and sustainable funding for health system utilization remains a significant challenge to the successful adoption of EMR. This study aims to identify the benefits and challenges associated with the adoption of Electronic Medical Records in the Federal Capital Territory (FCT) Hospitals in Abuja, Nigeria. A qualitative research method was employed to examine the benefits and challenges of adopting EMR in FCT hospitals. Questionnaires were administered to 310 participants, and collected data were analyzed using a thematic approach. The implementation of Electronic Medical Records (EMR) in FCT hospitals led to better healthcare services such as prompt tracking of patients’ records, and reduced costs associated with repetitive medical tests arising from the loss of patient files. Despite these benefits, a lack of sustainable funding and inadequate infrastructure technology were identified as major obstacles to the successful adoption of EMR in FCT hospitals. To ensure the continued use of EMR in FCT hospitals, it is essential to maintain efficient governance and regulation alongside upgrading the hospitals’ Information Communication Technology (ICT) infrastructures.

Exploring maturity of electronic medical record use among allied health professionals.

Electronic medical records (EMRs) have the potential to improve and streamline the quality and safety of patient care. Harnessing the full benefits of EMR implementation depends on the utilisation of advanced features, defined as "mature usage." At present, little is known about the maturity of EMR usage by allied health professionals (AHPs). To examine current maturity of EMR use by AHPs and explore perceived barriers to mature EMR utilisation and optimisation. AHPs were recruited from three health services. Participants completed a 27-question electronic questionnaire based on the EMR Adoption Framework, which measures clinician EMR utilisation (0 = paper chart, 5 = theoretical maximum) across 10 EMR feature categories. Interviews were conducted with both clinicians and managers to explore the nature of current EMR utilisation and perceived facilitators and barriers to mature usage. Questionnaire responses were obtained from 192 AHPs. The majority of questions (74%) showed a mean score of <3, indicating a lack of mature EMR use. Pockets of mature usage were identified in the categories of health information, referrals and administration processes. Interviews with 18 clinicians and managers revealed barriers to optimisation across three themes: (1) limited understanding of EMR opportunities; (2) complexity of the EMR change process and (3) end-user and environmental factors. Mature usage across EMR feature categories of the EMR Adoption Framework was low. However, questionnaire and qualitative interview data suggested pockets of mature utilisation. Achieving mature allied health EMR use will require strategies implemented at the clinician, EMR support, and service levels.

User Perceptions of Academic and Clinical Electronic Medical Records in an Undergraduate Nursing Program

Background: Electronic Medical Records (EMRs) are a widely used technology within health care. Nursing students require preparation during undergraduate education for the use of EMR. Nursing educators in universities also need to be proficient with EMR. This study reports the experiences and attitudes of nursing students and nurse educators using a simulated Academic Electronic Medical Record (AEMR) system within a nursing degree. Aim: To determine nursing student and nursing educator experience with and attitudes towards EMR and AEMR. Methods: Nursing students across three years of a Bachelor of Nursing program and nurse educators teaching with an AEMR system completed an online survey. Results: Findings from participating nursing students (n=103) revealed a favourable view of the learning and clinical relevance of AEMR (87.5%). Less than half (45.5%) of the surveyed students had been exposed to EMR whilst on clinical placements. In contrast most of the students (38.8%) who had been employed in a health care setting within the previous five years had used an EMR. Nurse educator responses (n=7) showed that most (n=5) had experience with EMR and viewed AEMR as important for student learning, with fewer (n=3) regarding it as an easy system to use. Conclusion: The survey revealed that both students and educators were satisfied with AEMR - and that AEMR use was acceptable for use in the University setting. However, the survey shows student exposure to EMR on placement is low. AEMR applications have the potential to bridge the gap in student experience however adequate support and training for academic staff in the use of AEMR is required.

Identifying contributors to disparities in patient access of online medical records: examining the role of clinician encouragement.

The aim of this study was to understand the influence of clinician encouragement and sociodemographic factors on whether patients access online electronic medical records (EMR). We analyzed 3279 responses from the Health Information National Trends Survey 5 cycle 4 survey, a cross-sectional, nationally representative survey administered by the National Cancer Institute. Frequencies and weighted proportions were calculated to compare clinical encouragement and access to their online EMR. Using multivariate logistic regression, we identified factors associated with online EMR use and clinician encouragement. In 2020, an estimated 42% of US adults accessed their online EMR and 51% were encouraged by clinicians to access their online EMR. In multivariate regression, respondents who accessed EMR were more likely to have received clinician encouragement (odds ratio [OR], 10.3; 95% confidence interval [CI], 7.7-14.0), college education or higher (OR, 1.9; 95% CI, 1.4-2.7), history of cancer (OR, 1.5; 95% CI, 1.0-2.3), and history of chronic disease (OR, 2.3; 95% CI, 1.7-3.2). Male and Hispanic respondents were less likely to have accessed EMR than female and non-Hispanic White respondents (OR, 0.6; 95% CI, 0.5-0.8, and OR, 0.5; 95% CI, 0.3-0.8, respectively). Respondents receiving encouragement from clinicians were more likely to be female (OR, 1.7; 95% CI, 1.3-2.3), have college education (OR, 1.5; 95% CI, 1.1-2.0), history of cancer (OR, 1.8; 95% CI, 1.3-2.5), and greater income levels (OR, 1.8-3.6). Clinician encouragement of patient EMR use is strongly associated with patients accessing EMR, and there are disparities in who receives clinician encouragement related to education, income, sex, and ethnicity. Clinicians have an important role to ensure that all patients benefit from online EMR use.

Experience of introducing electronic health records station in an objective structured clinical examination to evaluate medical students' communication skills in Canada: a descriptive study.

There is limited literature related to the assessment of electronic medical record (EMR)-related competencies. To address this gap, this study aims to explore the feasibility of EMR objective structured clinical examination (OSCE) station to evaluate the medical students' communication skills by psychometric study and standardized patients' (SPs) perspectives on EMR use in OSCE. An OSCE station that incorporated the use of an EMR was developed and pilot-tested in March 2022. Students' communication skills were assessed by SPs and physician examiners. Student's score in EMR station was compared with that of other 9 stations. Psychometric analysis, including item total correlation was done. SPs participated in a post-OSCE focus group to discuss their perception of EMRs' effect on communication. Ninety-nine 3rd year medical students participated in a 10-station OSCE that included the use of the EMR station. The EMR station had an acceptable item total correlation (0.217). Students who leveraged graphical displays in counseling received higher OSCE station scores from the SPs (P -value). Thematic analysis of the SP perception of students' EMR use from the focus group revealed the following domains of themes: technology, communication, case design, ownership of health information, and timing of EMR usage. This study demonstrated the feasibility of incorporating EMR in assessing learner communication skills in an OSCE. The EMR station had acceptable psychometric characteristics. Some medical students were able to efficiently use the EMRs as an aide in patient counseling. Teaching students how to be patient-centred even in the presence of technology may help with engagement.