Abstract
Background and Objective Finnish physicians have been increasingly dissatisfied with poor usability of the
electronic patient record (EPR) systems, which they have identified as an overload
factor in their work. Our aim is to specify which factors in EPRs are associated with
work-related well-being of physicians.
Methods A web-based questionnaire was sent to Finnish physicians younger than 65 years; the
responses (n = 3,781) represent one-fourth of these. This was a repetition of a survey in 2010,
where this questionnaire was used for the first time. In addition to statements assessing
usability, there were questions measuring time pressure and job control. The relation
between usability and work well-being was investigated with hierarchical multivariate
regression analyses: With time pressure and job control as dependent variables, EPR
usability assessments and physicians' background information were used as independent
variables.
Results In the multivariate analyses, technical problems that are often experienced in the
EPR were related to higher time pressure and lower job control. Active participation
in the development of the EPR system was related to stronger time pressure and stronger
job control. In addition, use of several systems daily and the experience of time-consuming
documentation of patient information for statistical purposes (billing, national registries,
and reporting) were related to higher time pressure, while those with longer experience
with the EPR system and those experiencing easy-to-read nursing records reported higher
job control.
Conclusion To relieve time pressure and increase sense of job control experienced by physicians,
usability, integrations, and stability of the EPR systems should be improved: fewer
login procedures, easier readability of nursing records, and decreased need for separate
documentation for statistical purposes. Physician participation in the EPR development
would increase the feeling of job control, but would add the time pressure. Hence,
time for developmental work should be arranged.
Keywords
electronic patient records and systems - patient records - specific software - clinical
IT systems - usability - workflows
