COMPUTERIZED PHYSICIAN ORDER ENTRY MEDICAL CENTER

Computerized Physician Order Entry Medical Center



Computerized Physician Order Entry Medical Center

Table of Content

Summary3

Introduction5

Theoretical Background6

Methods7

Setting8

Data Collection8

Participant Observation10

Interviews10

Videotaping of Clinical Encounters10

Data Analysis11

Results11

Relational Factors15

Educational Factors16

Structural Factors18

Discussion19

Conclusion and Limitations20

Computerized Physician Order Entry Medical Center

Summary

Purpose

Little is known about the effects of the Electronic Medical Record ( EMR) on physician-patient encounters. The objectives of this study were to identify the factors that influence the manner by which physicians use the EMR with patients.

Methods

This strategic analysis included 4 qualitative components: 80 hours of participant observation in 4 primary care offices in the Pacific Northwest; individual interviews with 52 patients, 12 office staff members, 23 physicians, and 1 nurse-practitioner; videotaped reviews of 29 clinical encounters; and 5 focus group interviews with physicians and computer advocates. The main outcome measures were factors that influence how physicians use the EMR. Researchers qualitatively derived these factors through serial reviews of data.

Results

This study identified 14 factors that influence how EMRs are used and perceived in medical practice today. These factors were categorized into 4 thematic domains: (1) spatial—effect of the physical presence and location of EMRs on interactions between physicians and patients; (2) relational—perceptions of physicians and patients about the EMR and how those perceptions affected its use; (3) educational—issues of developing physicians' proficiency with and improving patients' understandings about EMR use; and (4) structural—institutional and technological forces that influence how physicians perceived their use of EMR.

Conclusions

This study found that the introduction of EMRs into practice influences multiple cognitive and social dimensions of the clinical encounter. It brings into focus important questions that through further inquiry can determine how to make best use of the EMR to enhance therapeutic relationships.

Computerized Physician Order Entry Medical Center

Introduction

The electronic health record (EHR) is a new technology touted as a standard of practice for American medicine in the 21st century. The motivation to use computerized information systems in health care is driven by expectations that such systems will improve the quality of care, increase patient safety, and lower medical costs. The Electronic Medical Record (EMR) is a new technology touted as a standard of practice for American medicine in the 21st century.

Electronic medical record systems have the potential to provide substantial benefits to physicians, clinic practices, and health care organizations. These systems can facilitate workflow and improve the quality of patient care and patient safety. Application of information technology has been identified by the Institute of Medicine as one of the principal ways to improve the quality of health care.

In the United States, however, adoption of electronic medical records has been slow, and only about 7% of physicians use them. The cost of implementation is often cited as a barrier to their use. Although there are anecdotal reports suggesting that electronic medical records provide financial benefits by helping to reduce costs and improve revenues, few formal cost-benefit analyses have been done. Because their widespread adoption will depend in part on the ability to make a business case for financial ...