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Impact of Electronic versus Paper-Based Recording before EHR Implementation on Health Care Professionals' Perceptions of EHR Use, Data Quality, and Data Reuse.

ABSTRACT: BACKGROUND:The implementation of an electronic health record (EHR) with structured and standardized recording of patient data can improve data quality and reusability. Whether and how users perceive these advantages may depend on the preimplementation situation. OBJECTIVE:To determine whether the influence of implementing a structured and standardized EHR on perceived EHR use, data quality, and data reuse differed for users working with paper-based records versus a legacy EHR before implementation. METHODS:We used an electronic questionnaire to measure users' perception before implementation (2014), expected change, and perceived change after implementation (2016) on three themes. We included all health care professionals in two university hospitals in the Netherlands. Before jointly implementing the same structured and standardized EHR, one hospital used paper-based records and the other a legacy EHR. We compared perceptions before and after implementation for both centers. Additionally, we compared expected benefit with perceived benefit. RESULTS:We received 7,611 responses (4,537 before and 3,074 after implementation) of which 5,707 (75%) were from professionals reading and recording patient data. A total of 975 (13%) professionals responded to both before and after implementation questionnaires. In the formerly paper-based center staff perceived improvement in all themes after implementation. The legacy EHR center experienced deterioration of perceived EHR use and data reuse, and only one improvement in EHR use. In both centers, for half of the aspects at least 45% of responders experienced results worse than expected preimplementation. CONCLUSION:Our results indicate that the preimplementation recording practice impacts the perceived effect of the implementation of a structured and standardized EHR. For almost half of the respondents the new EHR did not meet their expectations. Especially legacy EHR centers need to investigate the expectations as these might be different and less clear cut than those in paper-based centers. These expectations need to be addressed appropriately to achieve a successful implementation.

SUBMITTER: Joukes E

PROVIDER: S-EPMC6426723 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Impact of Electronic versus Paper-Based Recording before EHR Implementation on Health Care Professionals' Perceptions of EHR Use, Data Quality, and Data Reuse.

Joukes Erik E de Keizer Nicolette F NF de Bruijne Martine C MC Abu-Hanna Ameen A Cornet Ronald R

Applied clinical informatics 20190320 2

<h4>Background</h4>The implementation of an electronic health record (EHR) with structured and standardized recording of patient data can improve data quality and reusability. Whether and how users perceive these advantages may depend on the preimplementation situation.<h4>Objective</h4>To determine whether the influence of implementing a structured and standardized EHR on perceived EHR use, data quality, and data reuse differed for users working with paper-based records versus a legacy EHR befo ...[more]

PMID: 30895574

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Project description:BackgroundThe predominant implementation paradigm of electronic health record (EHR) systems in low- and middle-income countries (LMICs) relies on standalone system installations at facilities. This implementation approach exacerbates the digital divide, with facilities in areas with inadequate electrical and network infrastructure often left behind. Mobile health (mHealth) technologies have been implemented to extend the reach of digital health, but these systems largely add to the problem of siloed patient data, with few seamlessly interoperating with the EHR systems that are now scaled nationally in many LMICs. Robust mHealth applications that effectively extend EHR systems are needed to improve access, improve quality of care, and ameliorate the digital divide.ObjectiveWe report on the development and scaled implementation of mUzima, an mHealth extension of the most broadly deployed EHR system in LMICs (OpenMRS).MethodsThe "Guidelines for reporting of health interventions using mobile phones: mobile (mHealth) evidence reporting assessment (mERA)" checklist was employed to report on the mUzima application. The World Health Organization (WHO) Principles for Digital Development framework was used as a secondary reference framework. Details of mUzima's architecture, core features, functionalities, and its implementation status are provided to highlight elements that can be adapted in other systems.ResultsmUzima is an open-source, highly configurable Android application with robust features including offline management, deduplication, relationship management, security, cohort management, and error resolution, among many others. mUzima allows providers with lower-end Android smartphones (version 4.4 and above) who work remotely to access historical patient data, collect new data, view media, leverage decision support, conduct store-and-forward teleconsultation, and geolocate clients. The application is supported by an active community of developers and users, with feature priorities vetted by the community. mUzima has been implemented nationally in Kenya, is widely used in Rwanda, and is gaining scale in Uganda and Mozambique. It is disease-agnostic, with current use cases in HIV, cancer, chronic disease, and COVID-19 management, among other conditions. mUzima meets all WHO's Principles of Digital Development, and its scaled implementation success has led to its recognition as a digital global public good and its listing in the WHO Digital Health Atlas.ConclusionsGreater emphasis should be placed on mHealth applications that robustly extend reach of EHR systems within resource-limited settings, as opposed to siloed mHealth applications. This is particularly important given that health information exchange infrastructure is yet to mature in many LMICs. The mUzima application demonstrates how this can be done at scale, as evidenced by its adoption across multiple countries and for numerous care domains.

Project description:The incorporation of data sharing into the research lifecycle is an important part of modern scholarly debate. In this study, the DataONE Usability and Assessment working group addresses two primary goals: To examine the current state of data sharing and reuse perceptions and practices among research scientists as they compare to the 2009/2010 baseline study, and to examine differences in practices and perceptions across age groups, geographic regions, and subject disciplines. We distributed surveys to a multinational sample of scientific researchers at two different time periods (October 2009 to July 2010 and October 2013 to March 2014) to observe current states of data sharing and to see what, if any, changes have occurred in the past 3-4 years. We also looked at differences across age, geographic, and discipline-based groups as they currently exist in the 2013/2014 survey. Results point to increased acceptance of and willingness to engage in data sharing, as well as an increase in actual data sharing behaviors. However, there is also increased perceived risk associated with data sharing, and specific barriers to data sharing persist. There are also differences across age groups, with younger respondents feeling more favorably toward data sharing and reuse, yet making less of their data available than older respondents. Geographic differences exist as well, which can in part be understood in terms of collectivist and individualist cultural differences. An examination of subject disciplines shows that the constraints and enablers of data sharing and reuse manifest differently across disciplines. Implications of these findings include the continued need to build infrastructure that promotes data sharing while recognizing the needs of different research communities. Moving into the future, organizations such as DataONE will continue to assess, monitor, educate, and provide the infrastructure necessary to support such complex grand science challenges.

Project description:BACKGROUND:With data becoming a centerpiece of modern scientific discovery, data sharing by scientists is now a crucial element of scientific progress. This article aims to provide an in-depth examination of the practices and perceptions of data management, including data storage, data sharing, and data use and reuse by scientists around the world. METHODS:The Usability and Assessment Working Group of DataONE, an NSF-funded environmental cyberinfrastructure project, distributed a survey to a multinational and multidisciplinary sample of scientific researchers in a two-waves approach in 2017-2018. We focused our analysis on examining the differences across age groups, sub-disciplines of science, and sectors of employment. FINDINGS:Most respondents displayed what we describe as high and mediocre risk data practices by storing their data on their personal computer, departmental servers or USB drives. Respondents appeared to be satisfied with short-term storage solutions; however, only half of them are satisfied with available mechanisms for storing data beyond the life of the process. Data sharing and data reuse were viewed positively: over 85% of respondents admitted they would be willing to share their data with others and said they would use data collected by others if it could be easily accessed. A vast majority of respondents felt that the lack of access to data generated by other researchers or institutions was a major impediment to progress in science at large, yet only about a half thought that it restricted their own ability to answer scientific questions. Although attitudes towards data sharing and data use and reuse are mostly positive, practice does not always support data storage, sharing, and future reuse. Assistance through data managers or data librarians, readily available data repositories for both long-term and short-term storage, and educational programs for both awareness and to help engender good data practices are clearly needed.

Dataset Information

Impact of Electronic versus Paper-Based Recording before EHR Implementation on Health Care Professionals' Perceptions of EHR Use, Data Quality, and Data Reuse.

Publications

Impact of Electronic versus Paper-Based Recording before EHR Implementation on Health Care Professionals' Perceptions of EHR Use, Data Quality, and Data Reuse.

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