scholarly journals Healthcare Provider Attitudes Towards the Problem List in an Electronic Health Record: A Mixed-Methods Qualitative Study

2014 ◽  
pp. 103-140
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Electronic Health Record ◽  
Healthcare Provider ◽  
Health Record ◽  
Problem List ◽  
Provider Attitudes ◽  
Electronic Health

scholarly journals Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods

2019 ◽  
Vol 27 (3) ◽  
pp. 480-490 ◽  
Author(s):  
Adam Rule ◽  
Michael F Chiang ◽  
Michelle R Hribar
Keyword(s):  
Systematic Review ◽  
Access Control ◽  
Electronic Health Record ◽  
Chart Review ◽  
Observational Research ◽  
Clinical Activity ◽  
Health Record ◽  
Problem List ◽  
Inclusion Criteria ◽  
Electronic Health

Abstract Objective To systematically review published literature and identify consistency and variation in the aims, measures, and methods of studies using electronic health record (EHR) audit logs to observe clinical activities. Materials and Methods In July 2019, we searched PubMed for articles using EHR audit logs to study clinical activities. We coded and clustered the aims, measures, and methods of each article into recurring categories. We likewise extracted and summarized the methods used to validate measures derived from audit logs and limitations discussed of using audit logs for research. Results Eighty-five articles met inclusion criteria. Study aims included examining EHR use, care team dynamics, and clinical workflows. Studies employed 6 key audit log measures: counts of actions captured by audit logs (eg, problem list viewed), counts of higher-level activities imputed by researchers (eg, chart review), activity durations, activity sequences, activity clusters, and EHR user networks. Methods used to preprocess audit logs varied, including how authors filtered extraneous actions, mapped actions to higher-level activities, and interpreted repeated actions or gaps in activity. Nineteen studies validated results (22%), but only 9 (11%) through direct observation, demonstrating varying levels of measure accuracy. Discussion While originally designed to aid access control, EHR audit logs have been used to observe diverse clinical activities. However, most studies lack sufficient discussion of measure definition, calculation, and validation to support replication, comparison, and cross-study synthesis. Conclusion EHR audit logs have potential to scale observational research but the complexity of audit log measures necessitates greater methodological transparency and validated standards.

scholarly journals Caregivers' role in using a personal electronic health record: a qualitative study of cancer patients and caregivers in Germany

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aline Weis ◽  
Sabrina Pohlmann ◽  
Regina Poss-Doering ◽  
Beate Strauss ◽  
Charlotte Ullrich ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Electronic Health Record ◽  
Cancer Patients ◽  
Health Record ◽  
Electronic Health

scholarly journals Electronic health record tools to assist with children’s insurance coverage: a mixed methods study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jennifer E. DeVoe ◽  
Megan Hoopes ◽  
Christine A. Nelson ◽  
Deborah J. Cohen ◽  
Aleksandra Sumic ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Electronic Health Record ◽  
Insurance Coverage ◽  
Mixed Methods Study ◽  
Health Record ◽  
Electronic Health

scholarly journals Do provider attitudes about electronic health records predict future electronic health record use?

Healthcare ◽  
2015 ◽  
Vol 3 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Tara F. Bishop ◽  
Mandy Smith Ryan ◽  
Colleen M. McCullough ◽  
Sarah C. Shih ◽  
Lawrence P. Casalino ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Health Record ◽  
Provider Attitudes ◽  
Health Records ◽  
Electronic Health

scholarly journals Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site

2011 ◽  
Vol 02 (01) ◽  
pp. 18-38 ◽  
Author(s):  
J.P. Weiner ◽  
K.H. Bowles ◽  
P. Abbott ◽  
H.P. Lehmann ◽  
P.S. Sockolow
Keyword(s):  
Nursing Home ◽  
Mixed Methods ◽  
Electronic Health Record ◽  
Functional Outcome ◽  
Decision Makers ◽  
Evidence Based ◽  
Health Record ◽  
Clinician Satisfaction ◽  
Electronic Health ◽  
The Impact

Summary Objective: Provide evidence-based advise to “Program of All-inclusive Care for the Elderly” (PACE) decision makers considering implementing an electronic health record (EHR) system, drawing on the results of a mixed methods study to examine: (1) the diffusion of an EHR among clinicians documenting direct patient care in a PACE day care site, (2) the impact of the use of the EHR on the satisfaction levels of clinicians, and (3) the impact of the use of the EHR on patient functional outcomes. Methods: Embedded mixed methods design with a post-test design quantitative experiment and concurrent qualitative component. Quantitative methods included: (1) the EHR audit log used to determine the frequency and timing during the week of clinicians’ usage of the system; (2) a 22-item clinician satisfaction survey; and (3) a 16-item patient functional outcome questionnaire related to locomotion, mobility, personal hygiene, dressing, feeding as well the use of adaptive devices. Qualitative methods included observations and open-ended, semi-structured follow-up interviews. Qualitative data was merged with the quantitative data by comparing the findings along themes. The setting was a PACE utilizing an EHR in Philadelphia: PACE manages the care of nursing-home eligible members to enable them to avoid nursing home admission and reside in their homes. Participants were 39 clinicians on the multi-disciplinary teams caring for the elders and 338 PACE members. Results: Clinicians did not use the system as intended, which may help to explain why the benefits related to clinical processes and patient outcomes as expected for an EHR were not reflected in the results. Clinicians were satisfied with the EHR, although there was a non-significant decline between 11 and 17 months post implementation of the EHR. There was no significant difference in patient functional outcome the two time periods. However, the sample size of 48 was too small to allow any conclusive statements to be made. Interpretation of findings underscores the importance of the interaction of workflow and EHR functionality and usability to impact clinician satisfaction, efficiency, and clinician use of the EHR. Conclusion: This research provides insights into EHR use in the care of the older people in community-based health care settings. This study assessed the adoption of an EHR outside the acute hospital setting and in the community setting to provide evidence-based recommendations to PACE decision makers considering implementing an EHR.

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