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Trends in Primary Care Clinician Perceptions of a New Electronic Health Record

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Abstract

Background

Clinician perceptions of a newly implemented electronic health record play an important role in its success or failure.

Objective

To measure changes in primary care clinician attitudes toward an electronic health record during the first year following implementation.

Design

Longitudinal survey.

Participants

86 primary care clinicians surveyed between December 2006 and January 2008.

Measurements

Perceived impact on overall quality of care, patient safety, communication, and efficiency at 1, 3, 6, and 12 months following implementation.

Results

Response rates for months 1, 3, 6, and 12 were 92%, 95%, 90%, and 82%, respectively. The proportion of clinicians agreeing that the EHR improved the overall quality of care (63% to 86%; p < 0.001), reduced medication-related errors (72% to 81%; p = 0.03), improved follow-up of test results (62% to 87%; p < 0.001), and improved communication among clinicians (72% to 93%; p < 0.001) increased from month 1 to month 12. During the same time period, a decreasing proportion of clinicians agreed that the EHR reduced the quality of patient interactions (49% to 33%; p = 0.001), resulted in longer patient visits (68% to 51%; p = 0.001), and increased time spent on medical documentation (78% to 68%; p = 0.006). Significant improvements in perceptions related to test result follow-up were first detected at 6 months, while those related to overall quality, efficiency, and communication were first identified at 12 months.

Conclusions

Primary care clinicians report increasingly positive perceptions of a new electronic health record within 1 year of implementation across a spectrum of domains of care.

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Acknowledgements

This study was funded by grants from the Agency for Healthcare Research and Quality (1 R01 HS 015226-01) and the National Library of Medicine (2 T15 LM 07092-16). These funding agencies played no role in the conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The authors would like to thank the clinicians of Atrius Health for participating in this study. Dr. Sequist had full access to all the data in the study and takes responsibility for the integrity and the accuracy of the data analysis.

Conflict of Interest

Dr. Sequist serves as a consultant on the Aetna External Advisory Committee for Racial and Ethnic Equality.

Author information

Authors and Affiliations

  1. Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, USA

    Robert El-Kareh MD, Tejal K. Gandhi MD, MPH, Eric G. Poon MD, MPH, Jonathan Ungar, Stuart Lipsitz ScD & Thomas D. Sequist MD, MPH

  2. Partners Healthcare System, Wellesley, MA, USA

    Eric G. Poon MD, MPH & Lisa P. Newmark

  3. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    Thomas D. Sequist MD, MPH

  4. Harvard Vanguard Medical Associates, Boston, MA, USA

    Thomas D. Sequist MD, MPH

Authors
  1. Robert El-Kareh MD
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  2. Tejal K. Gandhi MD, MPH
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  3. Eric G. Poon MD, MPH
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  4. Lisa P. Newmark
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  5. Jonathan Ungar
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  6. Stuart Lipsitz ScD
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  7. Thomas D. Sequist MD, MPH
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Corresponding author

Correspondence to Thomas D. Sequist MD, MPH.

Additional information

This study was funded by grants from the Agency for Healthcare Research and Quality (1 R01 HS 015226-01) and the National Library of Medicine (2 T15 LM 07092-16).

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El-Kareh, R., Gandhi, T.K., Poon, E.G. et al. Trends in Primary Care Clinician Perceptions of a New Electronic Health Record. J GEN INTERN MED 24, 464–468 (2009). https://doi.org/10.1007/s11606-009-0906-z

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  • DOI: https://doi.org/10.1007/s11606-009-0906-z

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