EMR study reveals divide between hospital and primary care sectors

The first large-scale study of Electronic Medical Record (EMR) usability in Australia has found nursing and medical professionals have differing experiences depending on where they work.

Led by Griffith University, the study published in The International Journal of Medical Informatics captured views from medical, nursing and allied health professionals across the acute, primary and community care sectors. Research partners included Monash University, Royal Melbourne Hospital, the University of Wollongong and the Australasian Institute of Digital Health.

Results showed technical and quality features were more positively experienced by doctors in the primary care sector than nurses, as well as ease of obtaining patient information and prevention of errors.

In the hospital sector, nurses’ experiences with EMRs were more positive with regards to support for routine task completion, learnability, ease of obtaining patient information and entry of patient data.

Medical professional respondents working in the hospital sector were less satisfied with usability features than their primary care counterparts (routine task completion, prevention of errors, medication mistakes, patient data).

“Usability features of information exchange and collaboration for clinicians across services and with patients is critical to reduce complications such as missed care, medication errors, compliance, and re-presentation,’’ said Dr Sheree Lloyd from Griffith University’s School of Applied Psychology.

“As well as the likelihood of increased errors, problems with EMRs can lead to fatigue and burnout.

“In the middle of a global pandemic, now more than ever we need to have a digitised system that is effective and easy to use for both medical and nursing professionals across sectors, but what we have found is that most EMRs have been designed as data collection tools rather than collaboration tools.

“In addition, most EMR systems used in Australian hospitals were developed in the US and may not be aligned to the workflows and practices of the Australian health care system.”

Another factor the researchers found that may have impeded usability was respondents being largely older, more experienced clinicians who, prior to EMR implementation, were likely expert users of paper-based record systems.

“While this varies from state to state, comprehensive EMR systems in hospitals have tended to be implemented later than those in the primary and community care sector,’’ said Dr Chris Bain, a Professor of Practice in Digital Health at Monash University.

“EMRs have traditionally targeted the role of doctors and have been designed from a biomedical perspective but now there’s much more emphasis on a collaborative approach to health and wellbeing with a variety of clinicians providing medical care to patients,’’ he said.

This study was based on a large-scale Finnish study to understand medical and nursing professionals’ experiences in the Australian context. The research team is hoping to repeat the study in 2022 to measure changes in usability and to gain a more complete picture of clinician concerns.