scholarly journals User Perspectives on Barriers and Facilitators to the Implementation of Electronic Health Records in Behavioral Hospitals: Qualitative Study

10.2196/18764 ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. e18764
Author(s):  
Se Young Jung ◽  
Hee Hwang ◽  
Keehyuck Lee ◽  
Donghyun Lee ◽  
Sooyoung Yoo ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Qualitative Study ◽  
Electronic Health Records ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
The United States ◽  
Barriers And Facilitators ◽  
Health Records ◽  
Electronic Health

Background Despite the rapid adoption of electronic health records (EHRs) resulting from the reimbursement program of the US government, EHR adoption in behavioral hospitals is still slow, and there remains a lack of evidence regarding barriers and facilitators to the implementation of mental health care EHRs. Objective The aim of this study is to analyze the experience of mental health professionals to explore the perceived barriers, facilitators, and critical ideas influencing the implementation and usability of a mental health care EHR. Methods In this phenomenological qualitative study, we interviewed physicians, nurses, pharmacists, mental health clinicians, and administrative professionals separately at 4 behavioral hospitals in the United States. We conducted semistructured interviews (N=43) from behavioral hospitals involved in the adoption of the mental health care EHR. Purposeful sampling was used to maximize the diversity. Transcripts were coded and analyzed for emergent domains. An exploratory data analysis was conducted. Results Content analyses revealed 7 barriers and 4 facilitators. The most important barriers to implementing the mental health care EHR were the low levels of computer proficiency among nurses, complexity of the system, alert fatigue, and resistance because of legacy systems. This led to poor usability, low acceptability, and distrust toward the system. The major facilitators to implementing the mental health care EHR were well-executed training programs, improved productivity, better quality of care, and the good usability of the mental health care EHR. Conclusions Health care professionals expected to enhance their work productivity and interprofessional collaboration by introducing the mental health care EHR. Routine education for end users is an essential starting point for the successful implementation of mental health care EHR electronic decision support. When adopting the mental health care EHR, managers need to focus on common practices in behavioral hospitals, such as documenting structured data in their organizations and adopting a seamless workflow of mental health care into the system.

scholarly journals Understanding optimisation processes of electronic health records (EHRs) in select leading hospitals: a qualitative study

2018 ◽  
Vol 25 (2) ◽  
pp. 109-125 ◽  
Author(s):  
Mark Chun Moon ◽  
Rebecca Hills ◽  
George Demiris
Keyword(s):  
United States ◽  
Qualitative Study ◽  
Electronic Health Records ◽  
Hospital Setting ◽  
The United States ◽  
Theory Approach ◽  
Health Records ◽  
High Performing ◽  
Advisory Groups ◽  
Electronic Health

BackgroundLittle is known about optimisation of electronic health records (EHRs) systems in the hospital setting while adoption of EHR systems continues in the United States.ObjectiveTo understand optimisation processes of EHR systems undertaken in leading healthcare organisations in the United States.MethodsInformed by a grounded theory approach, a qualitative study was undertaken that involved 11 in-depth interviews and a focus group with the EHR experts from the high performing healthcare organisations across the United States.ResultsThe study describes EHR optimisation processes characterised by prioritising exponentially increasing requests with predominant focus on improving efficiency of EHR, building optimisation teams or advisory groups and standardisation. The study discusses 16 types of optimisation that interdependently produced 16 results along with identifying 11 barriers and 20 facilitators to optimisation.ConclusionsThe study describes overall experiences of optimising EHRs in select high performing healthcare organisations in the US. The findings highlight the importance of optimising the EHR after, and even before, go-live and dedicating resources exclusively for optimisation.

scholarly journals Barriers and facilitators to data quality of electronic health records used for clinical research in China: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029314 ◽  
Author(s):  
Kaiwen Ni ◽  
Hongling Chu ◽  
Lin Zeng ◽  
Nan Li ◽  
Yiming Zhao
Keyword(s):  
Qualitative Study ◽  
Electronic Health Records ◽  
Clinical Research ◽  
Data Quality ◽  
Healthcare Professionals ◽  
Barriers And Facilitators ◽  
Health Records ◽  
Improve Data Quality ◽  
Electronic Health

ObjectivesThere is an increasing trend in the use of electronic health records (EHRs) for clinical research. However, more knowledge is needed on how to assure and improve data quality. This study aimed to explore healthcare professionals’ experiences and perceptions of barriers and facilitators of data quality of EHR-based studies in the Chinese context.SettingFour tertiary hospitals in Beijing, China.ParticipantsNineteen healthcare professionals with experience in using EHR data for clinical research participated in the study.MethodsA qualitative study based on face-to-face semistructured interviews was conducted from March to July 2018. The interviews were audiorecorded and transcribed verbatim. Data analysis was performed using the inductive thematic analysis approach.ResultsThe main themes included factors related to healthcare systems, clinical documentation, EHR systems and researchers. The perceived barriers to data quality included heavy workload, staff rotations, lack of detailed information for specific research, variations in terminology, limited retrieval capabilities, large amounts of unstructured data, challenges with patient identification and matching, problems with data extraction and unfamiliar with data quality assessment. To improve data quality, suggestions from participants included: better staff training, providing monetary incentives, performing daily data verification, improving software functionality and coding structures as well as enhancing multidisciplinary cooperation.ConclusionsThese results provide a basis to begin to address current barriers and ultimately to improve validity and generalisability of research findings in China.

Computers and process description for community mental health care

1997 ◽  
Vol 6 (S1) ◽  
pp. 81-90
Author(s):  
Rob Bale ◽  
Matthew Fiander ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Case Management ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Assertive Community Treatment ◽  
The United States ◽  
Community Treatment ◽  
Practice Characteristics

The focus of mental health care has seen a significant shift from institutional care to community based care and has been well described (Thornicroft & Bebbington, 1989). This shift has necessitated the development of new and flexible models for ensuring that patients' needs are met. Mental health professionals have to operate across a wide range of community contexts dealing with a complex range of needs. Intensive Case Management (ICM) also known as Assertive Community Treatment is a model of service provision to the long term mentally ill in the community. The Programme of Assertive Community Treatment (ACT) developed by Stein & Test (1980) in the United States has a number of Key elements (figure 1).ACT-based ICM is unusual in that it has been extensively researched (principally in the United States of America), and programmes are relatively well described. Such descriptions, especially of programmes outside America, often focus on underlying principals and philosophies and do little to measure practice. Teague et al. (1995), however, devised clear criteria for measuring practice components and McGrew et al. (1994) asked ACT “experts” to rate the “key” elements of PACT and related a number of these to levels of hospital use. In the United Kingdom, Thornicroft (1991) listed twelve axes for describing the central practice characteristics of case management (a broad concept including ICM). These UK ‘practice characteristics’ also focus more on macro-level programme description rather than on the practices of programme staff. There is a pressing need for research into exactly what teams do.

scholarly journals Mental health care professionals’ appraisal of patients’ use of online access to their electronic health record: a qualitative study. (Preprint)

2021 ◽  
Author(s):  
Antonius Mattheus van Rijt ◽  
Pauline Hulter ◽  
Anne Marie Weggelaar-Jansen ◽  
Kees Ahaus ◽  
Bettine Pluut
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Health Record ◽  
Patient Portal ◽  
Patient Access ◽  
Patient Portals ◽  
Electronic Health

BACKGROUND Patients, in a range of health care sectors, can access their medical health record using a patient portal. In mental health care, the use of patient portals among mental health care professionals (MHCPs) remains low. MHCPs worry that patient access to electronic health records will negatively affect the patient’s wellbeing and their own workload. This study explores the appraisal work carried out by MHCPs shortly after the introduction of online patient access and sheds light on the challenges MHCPs face when trying to make a patient portal work for them, the patient, and their relationship. OBJECTIVE This study aims to provide insights into the appraisal work of MHCPs to assess and understand patient access to their electronic health record (EHR) through a patient portal. METHODS We conducted a qualitative study including ten semi-structured interviews (N=11) and a focus group (N=10). Participants were MHCPs from different professional backgrounds and staff employees (e.g., team leaders, communication advisor). We collected data on their opinions and experiences with the recently implemented patient portal and their attempts to modify work practices. RESULTS Our study provides insights into MHCPs’ appraisal work to assess and understand patient access to the EHR through a patient portal. Four topics emerge from our data analysis: 1) appraising the effect on the patient-professional relationship, 2) appraising the challenge of sharing and registering delicate information, 3) appraising patient vulnerability, and 4) redefining consultation routines and registration practices. CONCLUSIONS MHCPs struggle with the effects of online patient access and are searching for the best ways to modify their registration and consultation practices. Our study suggests various solutions to the challenges faced by MHCPs. To optimize the effects of online patient access to EHRs, MHCPs need to be involved in the process of developing, implementing, and embedding patient portals.

scholarly journals Changes in community mental health services availability and suicide mortality in the US: A retrospective study

2020 ◽  
Author(s):  
Peiyin Hung ◽  
Susan Busch ◽  
Yi-Wen Shih ◽  
Alecia McGregor ◽  
Shi-Yi Wang
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
The United States ◽  
Suicide Mortality ◽  
Per Capita

Abstract Background: Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States. Methods: Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state. Results: From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3,406 to 2,920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (-0.52, 95% CI -1.08 to 0.03; p=0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths. Conclusions: State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts. Keywords: Suicide, Deinstitutionalization, Access to mental health care, Community mental health

scholarly journals Mental Health Issues in Adolescents and Young Adult African Immigrants

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Tolu Olupona ◽  
Oluwole Jegede ◽  
Clarety Keseke ◽  
Evaristo Akerele
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Young Adult ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
African Immigrants ◽  
The United States ◽  
African Immigrant

African Immigrants in the United States account for a rapidly growing population of immigrants in the country, constituting about four percent of the foreign-born population. The group has seen a significant population increase from 881,300 in 2010 to 1,606,914 in 2010. African immigrants are however not a monolithic population, as this number and diversity increases, there continues to be a growing need for mental health professionals to assess the peculiar mental health care needs and practices of this population. The primary African immigrant groups in the United States include Nigerians, Ethiopians, Egyptians, Ghanaians, and Kenyans. The delivery of optimal mental health care to this population involves a thorough comprehension of factors that influence mental health in African Immigrant populations. Such factors include the ethno-cultural background of families, the diversity of religions, immigration status, socio-economic status, language, family and sibling subsystems, identity issues and various forms of mental health stigma. Due to the complexity of these socioeconomic and cultural nuances, the mental illness presented by adolescents and young adult Africans are often atypical and their treatment requires appropriate cultural competence by physicians and mental health professionals. 

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