What do users think of EHRs?

The Kentucky Department of Corrections implemented an EHR system in 2006, ahead of the curve. All thirteen state-operated prisons, including their medical, dental, and surgical units and a psychiatric unit, were transitioned to a single EHR. After one year, the system was operational, which the authors of the article summarized here attribute to the procurement and selection process as well as good relations between management and users.

In particular, selection criteria included web-based access, built-in taxonomies like SNOMED and NDC, and the ability to generate meaningful reports for multiple purposes.

In 2010, Kentucky decided to evaluate user opinions of the current EHR system, using a survey of 173 users. EHR features, usability and respondent demographics were recorded. What did they find?

“Users were most satisfied with vital signs options, followed by the ability to document episodic visits, the ability to document chronic care visits, and the vital signs format. Users were least satisfied with the ability to track health maintenance, notification of lab alerts, the ability to track clinical notes by disease state, lab reports, and lab sign-offs.”

The majority of respondents were nurses, which may contribute to some of the task-oriented nature of the responses. Nurses are also the primary users of the system. Users also indicated some surprising facts, including that paper use had not decreased, nor had duplication of data.

Among users, nurse administrators and dentists were the least satisfied with the EHR, and dentists found the system least usable. These users have different needs than the majority of the EHR users, which suggests that custom templates or workflow alterations might be necessary. Still, when looking at the broad picture, overall, users were satisfied with the system. However, it points to a potential need for dental-specific information incorporated in EHRs.

Lessons Learned:

  • Periodic evaluation of user satisfaction can point out areas for improvement.
  • Most users are satisfied by EHR capabilities and usage.
  • Dentists may be atypical users in a health network, and software may require customization.

Gates, Madison & Roeder, Phillip. (2011) A Case Study of User Assessment of a Corrections Electronic Health Record. Perspectives in Health Information Management (Spring): 1-20.