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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2021

Open Access 01-12-2021 | Care | Research article

Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review

Authors: Rana Melissa Rahal, Jay Mercer, Craig Kuziemsky, Sanni Yaya

Published in: BMC Medical Informatics and Decision Making | Issue 1/2021

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Abstract

Background

Despite a substantial increase in the adoption of electronic medical records (EMRs) in primary health care settings, the use of advanced EMR features is limited. Several studies have identified both barriers and facilitating factors that influence primary care physicians’ (PCPs) use of advanced EMR features and the maturation of their EMR use. The purpose of this study is to explore and identify the factors that impact PCPs’ mature use of EMRs.

Methods

A systematic review was conducted in accordance with the Cochrane Handbook. The MEDLINE, Embase, and PsycINFO electronic databases were searched from 1946 to June 13, 2019. Two independent reviewers screened the studies for eligibility; to be included, studies had to address factors influencing PCPs’ mature use of EMRs. A narrative synthesis was conducted to collate study findings and to report on patterns identified across studies. The quality of the studies was also appraised.

Results

Of the 1893 studies identified, 14 were included in this study. Reported factors that influenced PCPs’ mature use of EMRs fell into one of the following 5 categories: technology, people, organization, resources, and policy. Concerns about the EMR system’s functionality, lack of physician awareness of EMR functionality, limited physician availability to learn more about EMRs, the habitual use of successfully completing clinical tasks using only basic EMR features, business-oriented organizational objectives, lack of vendor training, limited resource availability, and lack of physician readiness were reported as barriers to PCPs’ mature use of EMRs. The motivation of physicians, user satisfaction, coaching and peer mentoring, EMR experience, gender, physician perception, transition planning for changes in roles and work processes, team-based care, adequate technical support and training, sharing resources, practices affiliated with an integrated delivery system, financial incentives, and policies to increase EMR use all had a favorable impact on PCPs’ use of advanced EMR features.

Conclusions

By using a narrative synthesis to synthesize the evidence, we identified interrelated factors influencing the mature use of EMRs by PCPs. The findings underline the need to provide adequate training and policies that facilitate the mature use of EMRs by PCPs.
Trial registration: PROSPERO CRD42019137526.
Appendix
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Metadata
Title
Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review
Authors
Rana Melissa Rahal
Jay Mercer
Craig Kuziemsky
Sanni Yaya
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Care
Published in
BMC Medical Informatics and Decision Making / Issue 1/2021
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-021-01434-9

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