Physicians' and nurses' reactions to electronic medical records. Managerial and occupational implications.

Aims to understand the managerial implications of the perceptions hospital physicians and nurses hold toward the introduction of electronic medical records (EMRS). In-depth interviews were used with 18 hospital physicians and eight nurses from several different hospital wards at a large government-run, university-affiliated hospital in Israel, where EMRs were gradually introduced over the last 20 years. Physicians identified six different domains of impact. Senior physicians, most of whom held managerial roles, tended to emphasise managerial outcomes and to view these as positively affecting their organisations. Junior doctors emphasised mostly negative occupational effects of the EMR on their work--including limits to professional autonomy, heavier administrative burdens, and reinforcement of existing professional hierarchies. Nurses identified different domains and saw benefits for quality and administration of patient care.