Seven years after Meaningful Use: Physicians' and nurses' experiences with electronic health records. 2019

Cheryl Rathert, and Tracy H Porter, and Jessica N Mittler, and Michelle Fleig-Palmer
Cheryl Rathert, PhD, is Associate Professor, Department of Health Administration, Virginia Commonwealth University, Richmond. E-mail: crathert@vcu.edu. Tracy H. Porter, PhD, is Assistant Professor, Department of Management, Cleveland State University, Ohio. Jessica N. Mittler, PhD, is Associate Professor, Department of Health Administration, Virginia Commonwealth University, Richmond. Michelle Fleig-Palmer, PhD, is Associate Professor, Department of Management, University of Nebraska at Kearney.

Although the federal government's Meaningful Use electronic health record (EHR) implementation program resulted in some successes, there have been many challenges. The purpose of this study was to obtain detailed empirical data to better understand physicians' and nurses' experiences with EHRs. We conducted in-depth interviews with 30 physicians and nurses from two large health systems that were focused on attaining Stage 3 Meaningful Use criteria. Thematic framework analysis identified themes related to perceived benefits and challenges with EHR use. Participants appreciated benefits such as real-time patient data and easier access to information. Challenges included lack of interoperability across units, and this seemed to underlie many other noted challenges such as increased workload, insufficient training, and the perceived need for workarounds. Two key findings included mixed messages about trust in the EHR's information and its interference with interpersonal relationships. Results suggest that conservation of resources theory may be a useful strategy for understanding behaviors that enhance or undermine effective EHR use. Implications for policy and practice are discussed.

UI MeSH Term Description Entries
D007407 Interviews as Topic Works about conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes works about school admission or job interviews. Group Interviews,Interviewers,Interviews, Telephone,Oral History as Topic,Group Interview,Interview, Group,Interview, Telephone,Interviewer,Interviews, Group,Telephone Interview,Telephone Interviews
D009741 Nursing Staff, Hospital Personnel who provide nursing service to patients in a hospital. Hospital Nursing Staff,Hospital Nursing Staffs,Nursing Staffs, Hospital,Staff, Hospital Nursing,Staffs, Hospital Nursing
D010820 Physicians Individuals licensed to practice medicine. Physician
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001292 Attitude to Computers The attitude and behavior associated with an individual using the computer. Attitude to Computer,Computer, Attitude to,Computers, Attitude to,to Computer, Attitude,to Computers, Attitude
D014584 User-Computer Interface The portion of an interactive computer program that issues messages to and receives commands from a user. Interface, User Computer,Virtual Systems,User Computer Interface,Interface, User-Computer,Interfaces, User Computer,Interfaces, User-Computer,System, Virtual,Systems, Virtual,User Computer Interfaces,User-Computer Interfaces,Virtual System
D057286 Electronic Health Records Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online CONSUMER HEALTH INFORMATION that is relevant to the health conditions and treatments related to a specific patient. Electronic Health Record Data,Electronic Medical Record,Electronic Medical Records,Computerized Medical Record,Computerized Medical Records,Electronic Health Record,Medical Record, Computerized,Medical Records, Computerized,Health Record, Electronic,Health Records, Electronic,Medical Record, Electronic,Medical Records, Electronic
D062527 Meaningful Use Using certified ELECTRONIC HEALTH RECORDS technology to improve quality, safety, efficiency, and reduce HEALTHCARE DISPARITIES; engage patients and families in their health care; improve care coordination; improve population and public health; while maintaining privacy and security. Meaningful Uses,Use, Meaningful,Uses, Meaningful

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