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New Study Highlights Gaps in Implementation of Electronic Health Records

The use of electronic health records (EHRs) by health care professionals to track patient care was mandated by the 2009 HITECH Act. The implementation of EHRs was meant to better standardize care, improve communication between doctors and allow for enhanced analysis of treatment and disease. However, many stakeholders have argued that the mandated use of the technology has led to numerous challenges, including decreased relational time with patients and added care provider workloads. But few empirical studies have specifically examined the perceptions of doctors regarding how EHRs impact patient care or the ways in which the system can be reformed to improve utilization.

Now, a multi-university team, including Cleveland State University, has completed a qualitative study analyzing doctor perceptions of electronic health records, the positive outcomes of the technology and areas for improvement. Those surveyed indicated a number of clear challenges associated with the use of EHRs including: increased workload for care givers; issues around trust, both of the technology itself and information inputted by other physicians; perceived over-reliance on technology; and problems with user training. In addition, findings indicate that many doctors simply created their own “workarounds” that circumvented EHRs all together, while many medical professionals were also reluctant to speak up about their issues with the technology due to a “culture of silence” present at many medical institutions.

“There has been a lot of data collected about EHRs but little analysis of how the people using the technology actually feel about it,” notes Tracy Porter, college associate lecturer within the Department of Management at CSU and co-author of the study. “Our work indicates that there are clear problems being identified by the EHR user but due in part to workarounds and the culture of silence these issues are not being properly addressed, reducing the benefits of the technology and potentially leading to additional problems.”

Porter argues the data collected can be used to increase communication between physicians and administrators, help break down the culture of silence and directly address the issues medical professionals are experiencing. Her team will next seek to conduct a larger study including nurses as well as doctors, to assess how different care givers perceive EHR costs and benefits.

The study, which also included researchers from Virginia Commonwealth University and the University of Nebraska – Kearney, won a best paper award for empirical research from the Academy of Management and will be presented at the Academy’s 2016 Annual Meeting.