A Two-Year Longitudinal Assessment of Ophthalmologists’ Perceptions after Implementing an Electronic Health Record System

Joshua R. Ehrlich; Monica Michelotti; Taylor S. Blachley; Kai Zheng; Mick P. Couper; Grant M. Greenberg; Sharon Kileny; Greta L. Branford; David A. Hanauer; Jennifer S. Weizer

doi:10.4338/ACI-2016-05-RA-0075

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2016; 07(04): 930-945
DOI: 10.4338/ACI-2016-05-RA-0075

Research Article

Schattauer GmbH

A Two-Year Longitudinal Assessment of Ophthalmologists’ Perceptions after Implementing an Electronic Health Record System

Joshua R. Ehrlich

¹Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI

²Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI

,

Monica Michelotti

¹Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI

³Casey Eye Institute, Oregon Health and Science University, Portland, OR

,

Taylor S. Blachley

¹Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI

,

Kai Zheng

⁴Department of Health Policy and Management, School of Public Health, University of Michigan, Ann Arbor, MI

⁵School of Information, University of Michigan, Ann Arbor, MI

,

Mick P. Couper

⁶Institute for Social Research, University of Michigan, Ann Arbor, MI

,

Grant M. Greenberg

⁷Department of Family Medicine, University of Michigan, Ann Arbor, MI

,

Sharon Kileny

⁸Department of Pediatrics, University of Michigan, Ann Arbor, MI

,

Greta L. Branford

⁹Department of Internal Medicine, University of Michigan, Ann Arbor, MI

,

David A. Hanauer

⁵School of Information, University of Michigan, Ann Arbor, MI

⁸Department of Pediatrics, University of Michigan, Ann Arbor, MI

,

Jennifer S. Weizer

¹Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI

› Author Affiliations

Abstract

Summary

Objectives To understand the attitudes and perceptions of ophthalmologists toward an electronic health record (EHR) system, before and after its clinical implementation.

Methods Ophthalmologists at a single large academic ophthalmology department were surveyed longitudinally before and after implementation of a new EHR system. The survey measured ophthalmologists’ attitudes toward implementation of a new EHR. Questions focused on satisfaction, efficiency, and documentation. All attending physicians (between 56 and 61 at various time points) in the University of Michigan Department of Ophthalmology and Visual Sciences were surveyed. We plotted positive responses to survey questions and assessed whether perceptions followed a J-curve with an initial decrease followed by an increase surpassing pre-implementation levels.

Results Survey responses were received from 32 (52%) ophthalmologists pre-implementation, and 28 (46%) at 3 months, 35 (57%) at 7 months, 40 (71%) at 13 months and 39 (67%) at 24 months post-implementation. After EHR implementation respondents were more likely to express concerns about their ability to create high-quality documentation (p<0.01) and the impact of an electronic health record on meaningful patient interaction (p<0.01). Physicians did not report a significant change in the amount of time spent documenting outside of regular clinical work hours (p=0.54) or on their clinic efficiency and workflow (p=0.97). There was no significant change in overall job satisfaction during the study period (p=0.69). We did not observe a J-curve for any of the survey responses analyzed.

Conclusions As ophthalmology practices continue to transition to EHRs, adapting them to their specific culture and needs is important to maintain efficiency and user satisfaction. This study identifies areas of concern to ophthalmologists that may be addressed through education of physicians and customization of software as other practices move forward with EHR implementation.

Citation: Ehrlich JR, Michelotti M, Blachley TS, Zheng K, Couper MP, Greenberg GM, Kileny S, Branford GL, Hanauer DA, Weizer JS. A two-year longitudinal assessment of ophthalmologists’ perceptions after implementing an electronic health record system.

Keywords

Ophthalmology - implementation and deployment - electronic health records and systems - testing and evaluation - clinical documentation and communications

Full Text

References

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