Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2008

Open Access 01-12-2008 | Research article

Instant availability of patient records, but diminished availability of patient information: A multi-method study of GP's use of electronic patient records

Authors: Tom Christensen, Anders Grimsmo

Published in: BMC Medical Informatics and Decision Making | Issue 1/2008

Login to get access

Abstract

Background

In spite of succesful adoption of electronic patient records (EPR) by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR) systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship.

Methods

A combined qualitative and quantitative study that uses data collected from focus groups, observations of primary care encounters and a questionnaire survey of a random sample of general practitioners to describe their use of EPR in primary care.

Results

The overall availability of individual patient records had improved, but the availability of the information within each EPR was not satisfactory. GPs' use of EPRs were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians. We found no indications of disturbance of the clinician-patient relationship by use of computers in this study.

Conclusion

Although GPs are generally satisfied with their EPRs systems, there are still unmet needs and functionality to be covered. It is urgent to find methods that can make a better representation of information in large patient records as well as prevent EPRs from contributing to increased administrative workload of physicians.
Appendix
Available only for authorised users
Literature
1.
go back to reference Wyatt JC, Wyatt SM: When and how to evaluate health information systems?. Int J Med Inf. 2003, 69 (2-3): 251-259. 10.1016/S1386-5056(02)00108-9.CrossRef Wyatt JC, Wyatt SM: When and how to evaluate health information systems?. Int J Med Inf. 2003, 69 (2-3): 251-259. 10.1016/S1386-5056(02)00108-9.CrossRef
2.
go back to reference Powsner SM, Wyatt JC, Wright P: Opportunities for and challenges of computerisation. Lancet. 1998, 352: 6-10.1016/S0140-6736(98)08309-3.CrossRef Powsner SM, Wyatt JC, Wright P: Opportunities for and challenges of computerisation. Lancet. 1998, 352: 6-10.1016/S0140-6736(98)08309-3.CrossRef
3.
go back to reference Pizziferri L, Kittler AF, Volk LA, Honour MM, Gupta S, Wang S, Wang T, Lippincott M, Li Q, Bates DW: Primary care physician time utilization before and after implementation of an electronic health record: A time-motion study. J Biomed Inform. 2005, 38 (3): 176-188. 10.1016/j.jbi.2004.11.009.CrossRefPubMed Pizziferri L, Kittler AF, Volk LA, Honour MM, Gupta S, Wang S, Wang T, Lippincott M, Li Q, Bates DW: Primary care physician time utilization before and after implementation of an electronic health record: A time-motion study. J Biomed Inform. 2005, 38 (3): 176-188. 10.1016/j.jbi.2004.11.009.CrossRefPubMed
4.
go back to reference Lo H, Newmark L, Yoon C, Volk L, Carlson V, Kittler A, Lippincott M, Wang T, Bates D: Electronic health records in specialty care: a time-motion study. J Am Med Inform Assoc. 2007 Lo H, Newmark L, Yoon C, Volk L, Carlson V, Kittler A, Lippincott M, Wang T, Bates D: Electronic health records in specialty care: a time-motion study. J Am Med Inform Assoc. 2007
5.
go back to reference Sullivan F, Mitchell E: Has general practitioner computing made a difference to patient care? A systematic review of published reports. BMJ. 1995, 311: 848-852.CrossRefPubMedPubMedCentral Sullivan F, Mitchell E: Has general practitioner computing made a difference to patient care? A systematic review of published reports. BMJ. 1995, 311: 848-852.CrossRefPubMedPubMedCentral
6.
go back to reference Protti D, Wright G, Treweek S, Johansen I: Primary care computing in England and Scotland: a comparison with Denmark. Inform Prim Care. 2006, 14 (2): 93-99.PubMed Protti D, Wright G, Treweek S, Johansen I: Primary care computing in England and Scotland: a comparison with Denmark. Inform Prim Care. 2006, 14 (2): 93-99.PubMed
7.
go back to reference Henderson J, Britt H, Miller G: Extent and utilisation of computerisation in Australian general practice. Med J Aust. 2006, 185 (2): 84-87.PubMed Henderson J, Britt H, Miller G: Extent and utilisation of computerisation in Australian general practice. Med J Aust. 2006, 185 (2): 84-87.PubMed
8.
go back to reference Tange HJ: The paper-based patient record: Is it really so bad?. Comput Methods Programs Biomed. 1995, 48 (1): 127-131. 10.1016/0169-2607(95)01672-G.CrossRefPubMed Tange HJ: The paper-based patient record: Is it really so bad?. Comput Methods Programs Biomed. 1995, 48 (1): 127-131. 10.1016/0169-2607(95)01672-G.CrossRefPubMed
9.
go back to reference Booth N, Robinson P, Kohannejad J: Identification of high-quality consultation practice in primary care: the effects of computer use on doctor-patient rapport. Inform Prim Care. 2004, 12 (2): 75-83.PubMed Booth N, Robinson P, Kohannejad J: Identification of high-quality consultation practice in primary care: the effects of computer use on doctor-patient rapport. Inform Prim Care. 2004, 12 (2): 75-83.PubMed
10.
go back to reference Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet. 2001, 358 (9280): 483-488. 10.1016/S0140-6736(01)05627-6.CrossRefPubMed Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet. 2001, 358 (9280): 483-488. 10.1016/S0140-6736(01)05627-6.CrossRefPubMed
11.
go back to reference Neve K, Iversen R, Andersen C: Is it possible for nurses and doctors to form a useful clinical overview of an EHR?. Stud Health Technol Inform. 2006, 122: 314-319.PubMed Neve K, Iversen R, Andersen C: Is it possible for nurses and doctors to form a useful clinical overview of an EHR?. Stud Health Technol Inform. 2006, 122: 314-319.PubMed
12.
go back to reference Hammond J, Johnson HM, Varas R, Ward CG: A qualitative comparison of paper flowsheets vs a computer-based clinical information system. Chest. 1991, 99 (1): 155-10.1378/chest.99.1.155.CrossRefPubMed Hammond J, Johnson HM, Varas R, Ward CG: A qualitative comparison of paper flowsheets vs a computer-based clinical information system. Chest. 1991, 99 (1): 155-10.1378/chest.99.1.155.CrossRefPubMed
13.
go back to reference Miller RH, Sim I: Physicians' Use Of Electronic Medical Records: Barriers And Solutions. Health Affairs. 2004, 23 (2): 116-126. 10.1377/hlthaff.23.2.116.CrossRefPubMed Miller RH, Sim I: Physicians' Use Of Electronic Medical Records: Barriers And Solutions. Health Affairs. 2004, 23 (2): 116-126. 10.1377/hlthaff.23.2.116.CrossRefPubMed
14.
go back to reference Mikkelsen G, Aasly J: Concordance of information in parallel electronic and paper based patient records. Int J Med Inf. 2001, 63 (3): 123-131. 10.1016/S1386-5056(01)00152-6.CrossRef Mikkelsen G, Aasly J: Concordance of information in parallel electronic and paper based patient records. Int J Med Inf. 2001, 63 (3): 123-131. 10.1016/S1386-5056(01)00152-6.CrossRef
15.
go back to reference Carr-Bains S, de Lusignan S: Moving to paperlessness: a case study from a large general practice. Inform Prim Care. 2003, 11 (3): 157-165.PubMed Carr-Bains S, de Lusignan S: Moving to paperlessness: a case study from a large general practice. Inform Prim Care. 2003, 11 (3): 157-165.PubMed
16.
go back to reference Knottnerus J: Role of the electronic patient record in the development of general practice in The Netherlands. Methods Inf Med. 1999, 38 (4-5): 350-354.PubMed Knottnerus J: Role of the electronic patient record in the development of general practice in The Netherlands. Methods Inf Med. 1999, 38 (4-5): 350-354.PubMed
17.
go back to reference Poissant L, Pereira J, Tamblyn R, Kawasumi Y: The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review. JAMIA. 2005, 12 (5): 505-516.PubMedPubMedCentral Poissant L, Pereira J, Tamblyn R, Kawasumi Y: The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review. JAMIA. 2005, 12 (5): 505-516.PubMedPubMedCentral
18.
go back to reference Laerum H, Karlsen TH, Faxvaag A: Use of and attitudes to a hospital information system by medical secretaries, nurses and physicians deprived of the paper-based medical record: a case report. BMC Med Inform Decis Mak. 2004, 4: 18-10.1186/1472-6947-4-18.CrossRefPubMedPubMedCentral Laerum H, Karlsen TH, Faxvaag A: Use of and attitudes to a hospital information system by medical secretaries, nurses and physicians deprived of the paper-based medical record: a case report. BMC Med Inform Decis Mak. 2004, 4: 18-10.1186/1472-6947-4-18.CrossRefPubMedPubMedCentral
19.
go back to reference Cruickshank PJ: Computers in medicine: patients' attitudes. JR Coll Gen Pract. 1984, 34 (259): 77-80. Cruickshank PJ: Computers in medicine: patients' attitudes. JR Coll Gen Pract. 1984, 34 (259): 77-80.
20.
go back to reference Bright S: Nearest and dearest. Br J Healthcare Comput 1991; march: 58. 1991, 9: Bright S: Nearest and dearest. Br J Healthcare Comput 1991; march: 58. 1991, 9:
21.
go back to reference Monteiro E: Integrating Health Information Systems: A Critical Appraisal. Methods Inf Med. 2003, 42 (4): 428-432.PubMed Monteiro E: Integrating Health Information Systems: A Critical Appraisal. Methods Inf Med. 2003, 42 (4): 428-432.PubMed
22.
go back to reference Ford EW, Menachemi N, Phillips MT: Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless?. JAMIA. 2006, 13 (1): 106-112.PubMedPubMedCentral Ford EW, Menachemi N, Phillips MT: Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless?. JAMIA. 2006, 13 (1): 106-112.PubMedPubMedCentral
23.
go back to reference Weir CR, Crockett R, Gohlinghorst S, McCarthy C: Does user satisfaction relate to adoption behavior?: an exploratory analysis using CPRS implementation. AMIA Annual Symposium. 2000 Weir CR, Crockett R, Gohlinghorst S, McCarthy C: Does user satisfaction relate to adoption behavior?: an exploratory analysis using CPRS implementation. AMIA Annual Symposium. 2000
24.
go back to reference Lincoln YS: Emerging Criteria for Quality in Qualitative and Interpretive Research. Qualitative Inquiry. 1995, 1 (3): 275-10.1177/107780049500100301.CrossRef Lincoln YS: Emerging Criteria for Quality in Qualitative and Interpretive Research. Qualitative Inquiry. 1995, 1 (3): 275-10.1177/107780049500100301.CrossRef
25.
go back to reference Laerum H, Ellingsen G, Faxvaag A: Doctors' use of electronic medical records systems in hospitals: cross sectional survey. BMJ. 2001, 323 (7325): 1344-1348. 10.1136/bmj.323.7325.1344.CrossRefPubMedPubMedCentral Laerum H, Ellingsen G, Faxvaag A: Doctors' use of electronic medical records systems in hospitals: cross sectional survey. BMJ. 2001, 323 (7325): 1344-1348. 10.1136/bmj.323.7325.1344.CrossRefPubMedPubMedCentral
26.
go back to reference Mays N, Pope C: Qualitative Research: Rigour and qualitative research. BMJ. 1995, Br Med Assoc, 311 (6997): 109-112. Mays N, Pope C: Qualitative Research: Rigour and qualitative research. BMJ. 1995, Br Med Assoc, 311 (6997): 109-112.
27.
go back to reference Kaplan B, Shaw NT: Future directions in evaluation research: people, organizational, and social issues. Methods Inf Med. 2004, 43 (3): 215-231.PubMed Kaplan B, Shaw NT: Future directions in evaluation research: people, organizational, and social issues. Methods Inf Med. 2004, 43 (3): 215-231.PubMed
28.
go back to reference Chapple A: Explicit guidelines for qualitative research: a step in the right direction, a defence of the'soft' option, or a form of sociological imperialism?. Fam Pract. 1998, 15 (6): 556-561. 10.1093/fampra/15.6.556.CrossRefPubMed Chapple A: Explicit guidelines for qualitative research: a step in the right direction, a defence of the'soft' option, or a form of sociological imperialism?. Fam Pract. 1998, 15 (6): 556-561. 10.1093/fampra/15.6.556.CrossRefPubMed
Metadata
Title
Instant availability of patient records, but diminished availability of patient information: A multi-method study of GP's use of electronic patient records
Authors
Tom Christensen
Anders Grimsmo
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2008
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/1472-6947-8-12

Other articles of this Issue 1/2008

BMC Medical Informatics and Decision Making 1/2008 Go to the issue