Do EHRs Improve Care, Reduce Errors, or Affect Relationships?

Tom G. Bartol, NP


October 16, 2015

Nurse Practitioner Perceptions of the Impact of Electronic Medical Records Upon Clinical Practice

Borycki EM, Sangster-Gormley E, Schreiber R, Feddema A, Griffith J, Swamy M
Stud Health Technol Inform. 2015;218:45-51

Survey of Nurse Practitioners

This qualitative research out of British Columbia, Canada, explores the perceptions of how electronic medical records (EMRs) are affecting nurse practitioner (NP) clinical practice. The NP is a relatively new role in Canada, having been introduced in 2005, and is still a growing profession. NPs from British Columbia were invited to complete an online survey of 10 closed-ended questions focusing on quality of care, communications, and prescribing as well as two open-ended questions listing the benefits and challenges of using EMRs.

A total of 31 completed surveys were received—a response rate of 14%. Five respondents were using full EMRs, 17 were using a hybrid of paper and electronic records, and the other nine were using paper charts.

The findings indicated that NPs perceived EMRs to have a major positive impact on the quality of their clinical decisions, quality of care, access to information, communication, and prescribing. With respect to the effect of EMRs on the delivery of preventive care, approximately 47% of respondents said that EMRs had no impact, 36% said that EMRs had a positive impact (8% of whom characterized this as a "major positive impact"), 8% said that there was a negative impact, and the remaining 8% said that this was not applicable to their practice. With respect to the delivery of chronic care and meeting guidelines, 30% said EMRs had a major positive impact, 35% reported no impact, 9% reported a negative impact, and the remaining 26% said that this was not applicable to their practice.

The open-ended questions supplied more descriptive information. The benefits of EMRs were listed as consistent communication and remote access (from home) to diagnostic results, as well as continuity between providers of care. EMRs reduce the chances for medication error by eliminating illegible prescriptions. Complaints about EMRs include the fact that the computers are slow and frequently crash or freeze, or the entire system is down. Other challenges are problems with interoperability.

The researchers emphasized the importance of studying NP perceptions of EMRs so that they could provide input into the design of future systems.


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