Evaluation of EMR Implementation in a Private Hospital from User’s Perspective

Implementation of an electronic medical recordsystem increases efficiency of health services, quality of careand patient satisfaction. Successful implementation dependson multiple factors; one of which is users’ response to EMR.This study aimed to assess physicians and nurses’ views on theuse, quality and user satisfaction with EMR at a tertiarycare center in Karachi, Pakistan. Since its inception theHospital is accredited for being Pakistan’s first paperlesshospital. A cross-sectional survey was conducted using aself-administered questionnaire to evaluate use, quality and usersatisfaction with EMR. The questionnaire assessed: 1) computerrelated experience; 2) perceptions regarding EMR use; 3)quality of EMR system and 4) level of satisfaction with EMRsystem. The response rate was 75% nurses and 61% physicians.It was found that 80% of the respondents used EMR to obtainresults of patients’ investigations and test reports.81.6% respondents were of the opinion that the EMR Systemprovides the needed information about patients andreported their satisfaction with the accuracy of the system.Concerning user satisfaction with EMR, 94.6% of EMR usersbelieved that EMR is a useful system and 90.8% agreed on itssignificance for the better care of the patients. Type ofrespondents emerged as a significant correlate with overallusers’ satisfaction (p < 0.05). 90% respondents emphasized ona user-friendly EMR system and adequate training on its usage.Besides respondents, gender and computer relatedexperience have also significantly correlated with variousaspects of use, quality and user satisfaction with EMR (p <0.05). We were unable to correlate age with satisfaction with anEMR. EMR implementation positively effects workflow andpractice efficiency in a hospital. This study provides asystematic evaluation of various d imens ions of EMR andits correlates which is essential to understand reasons andbarriers for success, and methods to increase success inEMR implementation. Hospital management should ensure theavailability of technical expertise along with adequate trainingof HMIS staff

Design and Development of Simulation-based Instruction on Meaningful Use and Interprofessionalism Core Competencies in a Healthcare Team-based Learning Environment

Policymakers and electronic health records (EHR) experts agree that healthcare professionals lack proficiency in meaningful use of EHRs. This competency gap can result in increased medical errors. It is essential for health professions graduates to acquire skill sets that are adaptable to any electronic health information technologies including the EHRs to facilitate work process and information access. Simulation as an instructional method to create transformative learning experiences has shown promise in the medical profession. In simulations, learners are able to engage in real-life scenarios and practice their cognitive, affective, and psychomotor skills in a safe environment. The goal was to design and develop a simulation-based instructional module on meaningful use of EHR and interprofessional collaborative practice core competencies and evaluate students’ performance and satisfaction under an inter professional teambased setting. Using a design and development research approach, a simulation-based instructional module on meaningful use of EHR and interprofessional core competencies was designed. An internal validation of the module was conducted with an expert panel of medical professionals and instructional designers. Following validation, the instructional module was developed and pilot tested with a group of 21 second- and third year health professions students in medicine, pharmacy, and nursing in an interprofessional team-based learning environment. Students’ performance on meaningful use and interprofessionalism core competencies and their satisfaction during the simulation-based training were evaluated. The results confirmed that the students properly implemented the core competencies based on their performances during the immersive virtual patient encounter in the 3D virtual world. The analysis also showed how the students’ satisfaction was met as a reaction to the guided experiential learning’s (GEL) simulation-based instructional intervention, and in some instances were not sufficiently met. The analysis of the students’ testimonials further confirmed their overall satisfaction with the immersive simulation experience.The findings, based on the feedback from the students and faculty in this pilot implementation, highlighted simulation-based interactive gaming instruction and the hands-on experience in a 3D virtual world guided by GEL as an effective and engaging way to train healthcare professionals in the preparation to deliver care in a safe and effective manner under interprofessional team-based settings for better patient safety and outcome

A model on factors affecting nurses adoption of health information technology

Healthcare organisations are using Health Information Technology (HIT) to improve efficiency, reduce cost and reduce medical errors. This study focused on the factors that influence the acceptance of HIT among nurses in Saudi hospitals. This research used a 6 stage mixed-methods research approach. Literature was used to search for established models and frameworks of technology acceptance, and the many factors that could play a role. In the field study, the nature of practical HIT issues at the Prince Sultan Military Medical City (PSMMC) and the Heraa Hospital were studied, and combined with literature to create a HIT Implementation Issues Framework. The framework consolidates elements from the Technological, Organisational, Environmental and Human dimensions. The researcher participated in further PSMMC projects in the design and implementation of the new Cardio Pulmonary Resuscitation System and the Nurses and Pharmacists’ Communication System. From the implementation experience, pertinent factors were added to the Technology Acceptance Model and the “Nurses Acceptance Model” was proposed. The proposed model has eleven independent parameters, two dependent parameters, as well as seven moderators of key relationships. A questionnaire with 71 entries was distributed to over 2800 nurses in 52 wards in PSMMC. SPSS was used for data screening and descriptive statistics. The SmartPLS software was used for analysis and testing of the proposed hypotheses. The findings refined the “Nurses Acceptance Model” and highlight the significance of User Involvement and Training. The “Nurses Acceptance Model” enhances the scientific understanding of variables that affect technology acceptance among nurses in Saudi hospitals. The HIT Implementation Issues Framework helps hospital decision makers to plan HIT projects to improve the likelihood of successful adoption

A COMPREHENSIVE MODEL TO EXPLAINING USERS’ ACCEPTANCE AND INTENTION TO USE ELECTRONIC HEALTH RECORDS(EHR)IN REHABILITATION FACILITIES IN SAUDI ARABIA

This study provided a literature-based model that was developed by using a general and cumulative approach to explain user attitudes toward EHR. The model embodies the Theory of Reasoned Action (TRA), the Technology Acceptance Model (TAM), and the barriers that hinder users from proper use of the EHR system. Dimensions related to Human, Technological, Organizational, Professional, Legal, and Financial sources of influence were identified and tested in a special care setting. Because rehabilitation care facilities require an interdisciplinary (interactive) and multidisciplinary (additive) care approach, they pose an extra challenge. The current situation of the Saudi healthcare system demands a transition to a more connected and integrated system among different facilities of a single provider and across different providers. This situation underscores the need to have EHR in place and demands that particular attention be paid to user acceptance of the system. Thus, current and potential users of EHR in Saudi Arabia were targeted and asked to rate the importance of each source of influence on their attitudes toward EHR. The sample size was 319, comprising respondents from more than 20 hospitals and rehabilitation care facilities, and 263 responses were eligible for statistical analysis. Examining the model revealed that human, technological, organizational, and professional dimensions are the necessary and sufficient predictors for users in the tested settings. This calls for raising awareness of EHR and its anticipated benefits and difficulties. Continuous learning and ongoing training sessions are key aspects in attaining users’ acceptance of EHR. The findings of this study also call for developing policies and legal procedures to regulate the use of EHR in Saudi Arabia by establishing a national regulator and enforcement bodies to oversee issues related to system security and patient privacy. Furthermore, it is worth proposing an act or policy (stimuli) to promote the adoption and meaningful use of EHR and to keep costs of EHR low, especially for the private sector. Regarding future directions, the proposed model is to be taken to different levels and examined in different care settings, geographic areas, and with different technologies, including but not limited to mHealth, cloud computing, and telehealth