Summary
Objective: The slow adoption of electronic health record (EHR) systems has been linked to physician
resistance to change and the expense of EHR adoption. This qualitative study was conducted
to evaluate benefits, and clarify limitations of two mature, robust, comprehensive
EHR Systems by tech-savvy physicians where resistance and expense are not at issue.
Methods: Two EHR systems were examined – the paperless VistA / Computerized Patient Record
System used at the Veterans‘ Administration, and the General Electric Centricity Enterprise
system used at an academic medical center. A series of interviews was conducted with
20 EHR-savvy multi-institutional internal medicine (IM) faculty and house staff. Grounded
theory was used to analyze the transcribed data and build themes. The relevance and
importance of themes were constructed by examining their frequency, convergence, and
intensity.
Results: Despite eliminating resistance to both adoption and technology as drivers of acceptance,
these two robust EHR’s are still viewed as having an adverse impact on two aspects
of patient care, physician workflow and team communication. Both EHR’s had perceived
strengths but also significant limitations and neither were able to satisfactorily
address all of the physicians’ needs.
Conclusion: Difficulties related to physician acceptance reflect real concerns about EHR impact
on patient care. Physicians are optimistic about the future benefits of EHR systems,
but are frustrated with the non-intuitive interfaces and cumbersome data searches
of existing EHRs.
Keywords
Adoption - electronic health record
