The first national study of Electronic Medical Record (EMR) systems in Australia has found they rate poorly for usability and benefits with hospital doctors.
The survey that drew responses from 224 doctors (143 hospital-based and 81 GPs) found that EMRs were perceived by most in the hospital system to be difficult to use, of poor technical quality and with limited or no benefits in terms of preventing errors or sharing data with other health providers.
Many of the problems were blamed on the systems being developed for the US market with a focus on data collection and billing rather than supporting clinicians to improve workflow for better patient care.
Responses from doctors using hospital-based EMR systems general scored about half of those of doctors using EMR systems designed for GPs, perhaps reflecting the wider adoption and longer experience of EMR systems in primary care, the study investigators from Griffith University said.
“Software glitches, dropdown menus, clicks, alerts and the disconnected patchwork of systems without seamless interoperability have been linked to ‘near misses’ and a higher risk of professional burnout,” they wrote in the International Journal of Medical Informatics.
The results showed that a low proportion of hospital doctors agreed with the following statements about EMR:
- Stable technical functionality (does not crash, no downtime) – 59% hospital vs 82% GP
- EMR responds quickly to inputs – 47% hospital vs 82% GP
- Information sometimes disappears – 41% hospital vs 21% GP
- Ease of use: fields and functions arranged logically – 28% hospital vs 69% GP
- Titles and labels clear and understandable – 35% hospital vs 79% GP
- Routine tasks straightforward without need for extra steps – 22% hospital vs 58% GP
- Can be used with a lot of training – 17% hospital vs 57% GP
- Easy to obtain patient info – 36% hospital vs 71% GP
- Data entry is quick, easy and smooth – 22% hospital vs 65% GP
- EMR system helps prevent medication errors – 38% hospital vs 75% GP
- EMR systems support information sharing between clinicians in same service – 62% hospital vs 74% GP
- Supports information sharing between clinicians in different health services – 17% hospital vs 21% GP
- Supports information sharing and collaboration between clinicians and patients – 9% hospital vs 31% GP
Study authors Dr Sheree Lloyd from Griffith University’s School of Applied Psychology said the findings had important implications because EMR usability was critical to reduce complications such as missed care, medication errors, compliance, and re-presentation.