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'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system

BACKGROUND: The Veterans Health Administration (VA) has invested significant resources in designing and implementing a comprehensive electronic health record (EHR) that supports clinical priorities. EHRs in general have been difficult to implement, with unclear cost-effectiveness. We describe VA cli...

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Autores principales: Bonner, Laura M, Simons, Carol E, Parker, Louise E, Yano, Elizabeth M, Kirchner, JoAnn E
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931450/
https://www.ncbi.nlm.nih.gov/pubmed/20727182
http://dx.doi.org/10.1186/1748-5908-5-63
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author Bonner, Laura M
Simons, Carol E
Parker, Louise E
Yano, Elizabeth M
Kirchner, JoAnn E
author_facet Bonner, Laura M
Simons, Carol E
Parker, Louise E
Yano, Elizabeth M
Kirchner, JoAnn E
author_sort Bonner, Laura M
collection PubMed
description BACKGROUND: The Veterans Health Administration (VA) has invested significant resources in designing and implementing a comprehensive electronic health record (EHR) that supports clinical priorities. EHRs in general have been difficult to implement, with unclear cost-effectiveness. We describe VA clinical personnel interactions with and evaluations of the EHR. METHODS: As part of an evaluation of a quality improvement initiative, we interviewed 72 VA clinicians and managers using a semi-structured interview format. We conducted a qualitative analysis of interview transcripts, examining themes relating to participants' interactions with and evaluations of the VA EHR. RESULTS: Participants described their perceptions of the positive and negative effects of the EHR on their clinical workflow. Although they appreciated the speed and ease of documentation that the EHR afforded, they were concerned about the time cost of using the technology and the technology's potential for detracting from interpersonal interactions. CONCLUSIONS: VA personnel value EHRs' contributions to supporting communication, education, and documentation. However, participants are concerned about EHRs' potential interference with other important aspects of healthcare, such as time for clinical care and interpersonal communication with patients and colleagues. We propose that initial implementation of an EHR is one step in an iterative process of ongoing quality improvement.
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spelling pubmed-29314502010-09-02 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system Bonner, Laura M Simons, Carol E Parker, Louise E Yano, Elizabeth M Kirchner, JoAnn E Implement Sci Research Article BACKGROUND: The Veterans Health Administration (VA) has invested significant resources in designing and implementing a comprehensive electronic health record (EHR) that supports clinical priorities. EHRs in general have been difficult to implement, with unclear cost-effectiveness. We describe VA clinical personnel interactions with and evaluations of the EHR. METHODS: As part of an evaluation of a quality improvement initiative, we interviewed 72 VA clinicians and managers using a semi-structured interview format. We conducted a qualitative analysis of interview transcripts, examining themes relating to participants' interactions with and evaluations of the VA EHR. RESULTS: Participants described their perceptions of the positive and negative effects of the EHR on their clinical workflow. Although they appreciated the speed and ease of documentation that the EHR afforded, they were concerned about the time cost of using the technology and the technology's potential for detracting from interpersonal interactions. CONCLUSIONS: VA personnel value EHRs' contributions to supporting communication, education, and documentation. However, participants are concerned about EHRs' potential interference with other important aspects of healthcare, such as time for clinical care and interpersonal communication with patients and colleagues. We propose that initial implementation of an EHR is one step in an iterative process of ongoing quality improvement. BioMed Central 2010-08-20 /pmc/articles/PMC2931450/ /pubmed/20727182 http://dx.doi.org/10.1186/1748-5908-5-63 Text en Copyright ©2010 Bonner et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bonner, Laura M
Simons, Carol E
Parker, Louise E
Yano, Elizabeth M
Kirchner, JoAnn E
'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system
title 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system
title_full 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system
title_fullStr 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system
title_full_unstemmed 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system
title_short 'To take care of the patients': Qualitative analysis of Veterans Health Administration personnel experiences with a clinical informatics system
title_sort 'to take care of the patients': qualitative analysis of veterans health administration personnel experiences with a clinical informatics system
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931450/
https://www.ncbi.nlm.nih.gov/pubmed/20727182
http://dx.doi.org/10.1186/1748-5908-5-63
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