Literature DB >> 24001517

You and me and the computer makes three: variations in exam room use of the electronic health record.

Jason J Saleem1, Mindy E Flanagan, Alissa L Russ, Carmit K McMullen, Leora Elli, Scott A Russell, Katelyn J Bennett, Marianne S Matthias, Shakaib U Rehman, Mark D Schwartz, Richard M Frankel.   

Abstract

Challenges persist on how to effectively integrate the electronic health record (EHR) into patient visits and clinical workflow, while maintaining patient-centered care. Our goal was to identify variations in, barriers to, and facilitators of the use of the US Department of Veterans Affairs (VA) EHR in ambulatory care workflow in order better to understand how to integrate the EHR into clinical work. We observed and interviewed 20 ambulatory care providers across three geographically distinct VA medical centers. Analysis revealed several variations in, associated barriers to, and facilitators of EHR use corresponding to different units of analysis: computer interface, team coordination/workflow, and organizational. We discuss our findings in the context of different units of analysis and connect variations in EHR use to various barriers and facilitators. Findings from this study may help inform the design of the next generation of EHRs for the VA and other healthcare systems.

Entities:  

Keywords:  Clinical documentation; Electronic health records; Provider-patient communication; Workflow

Mesh：

Year:  2013        PMID： 24001517      PMCID： PMC3957404          DOI： 10.1136/amiajnl-2013-002189

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN： 1067-5027            Impact factor:   4.497


  22 in total

1.  Medscape's response to the Institute of Medicine Report: Crossing the quality chasm: a new health system for the 21st century.

Authors:  M Leavitt
Journal:  MedGenMed       Date:  2001-03-05

2.  VistA--U.S. Department of Veterans Affairs national-scale HIS.

Authors:  Steven H Brown; Michael J Lincoln; Peter J Groen; Robert M Kolodner
Journal:  Int J Med Inform       Date:  2003-03       Impact factor: 4.046

3.  Informatics resources to support health care quality improvement in the veterans health administration.

Authors:  Denise M Hynes; Ruth A Perrin; Steven Rappaport; Joanne M Stevens; John G Demakis
Journal:  J Am Med Inform Assoc       Date:  2004-06-07       Impact factor: 4.497

4.  Clinician style and examination room computers: a video ethnography.

Authors:  William Ventres; Sarah Kooienga; Ryan Marlin; Nancy Vuckovic; Valerie Stewart
Journal:  Fam Med       Date:  2005-04       Impact factor: 1.756

Review 5.  A descriptive feast but an evaluative famine: systematic review of published articles on primary care computing during 1980-97.

Authors:  E Mitchell; F Sullivan
Journal:  BMJ       Date:  2001-02-03

6.  Patients' and physicians' understanding of health and biomedical concepts: relationship to the design of EMR systems.

Authors:  Vimla L Patel; José F Arocha; André W Kushniruk
Journal:  J Biomed Inform       Date:  2002-02       Impact factor: 6.317

7.  Healthcare information technology's relativity problems: a typology of how patients' physical reality, clinicians' mental models, and healthcare information technology differ.

Authors:  Sean W Smith; Ross Koppel
Journal:  J Am Med Inform Assoc       Date:  2013-06-25       Impact factor: 4.497

8.  Exploring barriers and facilitators to the use of computerized clinical reminders.

Authors:  Jason J Saleem; Emily S Patterson; Laura Militello; Marta L Render; Greg Orshansky; Steven M Asch
Journal:  J Am Med Inform Assoc       Date:  2005-03-31       Impact factor: 4.497

9.  Identifying barriers to the effective use of clinical reminders: bootstrapping multiple methods.

Authors:  Emily S Patterson; Bradley N Doebbeling; Constance H Fung; Laura Militello; Shilo Anders; Steven M Asch
Journal:  J Biomed Inform       Date:  2004-12-15       Impact factor: 6.317

10.  Diabetes care quality in the Veterans Affairs Health Care System and commercial managed care: the TRIAD study.

Authors:  Eve A Kerr; Robert B Gerzoff; Sarah L Krein; Joseph V Selby; John D Piette; J David Curb; William H Herman; David G Marrero; K M Venkat Narayan; Monika M Safford; Theodore Thompson; Carol M Mangione
Journal:  Ann Intern Med       Date:  2004-08-17       Impact factor: 25.391
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  19 in total

1.  Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report.

Authors:  Christopher A Harle; Alyson Listhaus; Constanza M Covarrubias; Siegfried Of Schmidt; Sean Mackey; Peter J Carek; Roger B Fillingim; Robert W Hurley
Journal:  J Am Med Inform Assoc       Date:  2015-07-09       Impact factor: 4.497

2.  Understanding barriers and facilitators to the use of Clinical Information Systems for intensive care units and Anesthesia Record Keeping: A rapid ethnography.

Authors:  Jason J Saleem; William R Plew; Ross C Speir; Jennifer Herout; Nancy R Wilck; Dale Marie Ryan; Theresa A Cullen; Jean M Scott; Murielle S Beene; Toni Phillips
Journal:  Int J Med Inform       Date:  2015-03-24       Impact factor: 4.046

3.  Promoting Quality Face-to-Face Communication during Ophthalmology Encounters in the Electronic Health Record Era.

Authors:  Sally L Baxter; Helena E Gali; Michael F Chiang; Michelle R Hribar; Lucila Ohno-Machado; Robert El-Kareh; Abigail E Huang; Heather E Chen; Andrew S Camp; Don O Kikkawa; Bobby S Korn; Jeffrey E Lee; Christopher A Longhurst; Marlene Millen
Journal:  Appl Clin Inform       Date:  2020-02-19       Impact factor: 2.342

4.  Residents' Insights and Ideas about Screen-Sharing in Primary Care Clinics.

Authors:  Kathlyn E Fletcher; Onur Asan; Jeanne Tyszka
Journal:  Appl Clin Inform       Date:  2017-12-14       Impact factor: 2.342

5.  Provider Preference in Exam Room Layout Design and Computing.

Authors:  Jacob M Read; Dustin T Weiler; Tyler Satterly; Catarina Soares; Jason J Saleem
Journal:  Appl Clin Inform       Date:  2019-12-25       Impact factor: 2.342

Review 6.  Impact of Electronic Medical Record Use on the Patient-Doctor Relationship and Communication: A Systematic Review.

Authors:  Maria Alcocer Alkureishi; Wei Wei Lee; Maureen Lyons; Valerie G Press; Sara Imam; Akua Nkansah-Amankra; Deb Werner; Vineet M Arora
Journal:  J Gen Intern Med       Date:  2016-01-19       Impact factor: 5.128

7.  How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care.

Authors:  Onur Asan; Henry N Young; Betty Chewning; Enid Montague
Journal:  Patient Educ Couns       Date:  2014-12-12

8.  Strategizing EHR use to achieve patient-centered care in exam rooms: a qualitative study on primary care providers.

Authors:  Jing Zhang; Yunan Chen; Shazia Ashfaq; Kristin Bell; Alan Calvitti; Neil J Farber; Mark T Gabuzda; Barbara Gray; Lin Liu; Steven Rick; Richard L Street; Kai Zheng; Danielle Zuest; Zia Agha
Journal:  J Am Med Inform Assoc       Date:  2015-11-13       Impact factor: 4.497

9.  Field Investigation of Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Pilot Study.

Authors:  Jason J Saleem; Dustin T Weiler; Tyler Satterly; Maury A Nussbaum; Neale R Chumbler; Gary M Fischer; Shakaib U Rehman
Journal:  Proc Hum Factors Ergon Soc Annu Meet       Date:  2018-09-25

10.  More screen time, less face time - implications for EHR design.

Authors:  Onur Asan; Paul D Smith; Enid Montague
Journal:  J Eval Clin Pract       Date:  2014-05-19       Impact factor: 2.431
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