Emergency department and urgent care clinician perspectives on digital access to past medical histories

OBJECTIVE: To explore emergency department (ED) and urgent care (UC) clinicians’ perceptions of digital access to patients’ past medical history (PMH). METHODS: An online survey compared anticipated and actual value of access to digital PMH. UTAUT2 (Unified Theory of Acceptance and Use of Technology 2) was used to assess technology acceptance. Quantitative data were analysed using Mann-Whitney U tests and qualitative data were analysed using a general inductive approach. RESULTS: 33 responses were received. 94% (16/17) of respondents with PMH access said they valued their PMH system and all respondents with no digital PMH access (100%; 16/16) said they believed access would be valuable. Both groups indicated a high level of technology acceptance across all UTAUT2 dimensions. Free-text responses suggested improvements such as increasing the number of patient records available, standardisation of information presentation, increased system reliability, expanded access to information and validation by authoritative/trusted sources. DISCUSSION: Non-PMH respondents’ expectations were closely matched with the benefits obtained by PMH respondents. High levels of technology acceptance indicated a strong willingness to adopt. Clinicians appeared clear about the improvements they would like for PMH content and access. Policy implications include the need to focus on higher levels of patient participation, and increasing the breadth and depth of information and processes to ensure patient record curation and stewardship. CONCLUSION: There appears to be strong clinician support for digital access to PMH in ED and UC; however, current systems appear to have many shortcomings.