End-Users' Voice in EHR Selection : Development of a Usability Questionnaire for Demonstrations in Procurement (DPUQ)

This paper describes the development of a questionnaire for evaluating usability during EHR system procurement (DPUQ). Established usability questionnaires can be used to gather user feedback after using the systems. However, during procurement, experimenting with real system use is practical only with a limited number of system candidates. There is a need for less resource-demanding usability evaluation in the early stages of procurement in cases with several vendors. DPUQ has been designed for usability evaluation by end-users during special scenario-based vendor demonstrations. The questionnaire includes three sets of questions to be used during and after the vendor demonstration. DPUQ delivers specific usability scores and can be used to compare system candidates in procurement complementing other evaluation methods.Peer reviewe

An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan

<p>Abstract</p> <p>Background</p> <p>Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters.</p> <p>Methods</p> <p>This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data.</p> <p>Results</p> <p>The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction.</p> <p>Conclusion</p> <p>It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust.</p

Developing a theoretical model and questionnaire survey instrument to measure the success of electronic health records in residential aged care

Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes. The proposed research model incorporates six variables in the reformulated DeLone and McLean information systems success model: system quality, information quality, service quality, use, user satisfaction and net benefits. Two variables training and self-efficacy were also incorporated into the model. A questionnaire survey instrument was designed to measure the eight variables in the model. After a pilot test, the measurement scale was used to collect data from 243 nursing staff members in 10 residential aged care homes belonging to three management groups in Australia. Partial least squares path modeling was conducted to validate the model. The validated EHR systems success model predicts the impact of the four antecedent variablesÐtraining, self-efficacy, system quality and information qualityÐon the net benefits, the indicator of EHR systems success, through the intermittent variables use and user satisfaction. A 24-item measurement scale was developed to quantitatively evaluate the performance of an EHR system. The parsimonious EHR systems success model and the measurement scale can be used to benchmark EHR systems success across organizations and units and over time

Sharing and viewing segments of electronic patient records service (SVSEPRS) using multidimensional database model

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The concentration on healthcare information technology has never been determined than it is today. This awareness arises from the efforts to accomplish the extreme utilization of Electronic Health Record (EHR). Due to the greater mobility of the population, EHR will be constructed and continuously updated from the contribution of one or many EPRs that are created and stored at different healthcare locations such as acute Hospitals, community services, Mental Health and Social Services. The challenge is to provide healthcare professionals, remotely among heterogeneous interoperable systems, with a complete view of the selective relevant and vital EPRs fragments of each patient during their care. Obtaining extensive EPRs at the point of delivery, together with ability to search for and view vital, valuable, accurate and relevant EPRs fragments can be still challenging. It is needed to reduce redundancy, enhance the quality of medical decision making, decrease the time needed to navigate through very high number of EPRs, which consequently promote the workflow and ease the extra work needed by clinicians. These demands was evaluated through introducing a system model named SVSEPRS (Searching and Viewing Segments of Electronic Patient Records Service) to enable healthcare providers supply high quality and more efficient services, redundant clinical diagnostic tests. Also inappropriate medical decision making process should be avoided via allowing all patients‟ previous clinical tests and healthcare information to be shared between various healthcare organizations. Multidimensional data model, which lie at the core of On-Line Analytical Processing (OLAP) systems can handle the duplication of healthcare services. This is done by allowing quick search and access to vital and relevant fragments from scattered EPRs to view more comprehensive picture and promote advances in the diagnosis and treatment of illnesses. SVSEPRS is a web based system model that helps participant to search for and view virtual EPR segments, using an endowed and well structured Centralised Multidimensional Search Mapping (CMDSM). This defines different quantitative values (measures), and descriptive categories (dimensions) allows clinicians to slice and dice or drill down to more detailed levels or roll up to higher levels to meet clinicians required fragment

Health Information Technology in US Hospitals: Analysis of Current Status and Development of Future Strategies

Adopting Electronic Health Records (EHR) improves the efficiency and quality of health care systems. However, recent studies reported a slow rate of adoption or conflicting study results regarding EHR implementation in the United States. Even though there appears to be a substantial difference in terms of EHRs implementation and adoption among hospitals with different organizational characteristics and by end-users in different job categories, little has been studied about the relationship between EHR implementation and different organizational and end-users’ characteristics. To evaluate the current status of EHRs implementation and adoption and to compare how differences in organizational and end-user characteristics relate to EHR adoption and implementation, we analyzed secondary data from HIMSS Analytics® annual survey of 2013 and primary data from end-user surveys using various statistical analysis techniques including multivariable regression analysis, multinomial logistic regression analysis, and information theoretic analysis using normalized mutual information (NMI). This study was based on various theories including an organizational learning theory, a theory of organizational readiness for change, the Technology Acceptance Model (TAM) and Andersen and Aday’s behavioral model. We found discernable differences in EHR implementation and adoption among hospitals with different organizational contextual factors. Most notable was a strong link between hospital location and EHR implementation. Rural hospitals lagged behind urban hospitals in terms of EHRs implementation demonstrating a lower level of readiness for meaningful use attainment. Hospitals in different locations selected and used different EHR vendors based upon location specific evidence related to attaining meaningful use. We also found that EHR end-users across different job categories had different perceptions toward EHRs, which ultimately influenced their satisfaction with EHRs. For successful EHR implementation and adoption, health care managers need to develop and customize EHR implementation strategies. Instead of applying one uniform strategy, health care managers need to prioritize their resources and focus their efforts according to different organizational contexts and different end-user expectations toward EHRs. As rural areas will be disadvantaged in terms of quality and efficiency if rural hospitals continue to struggle with EHR implementation, we need to pay special attention to EHRs implementation in rural hospitals

Planned implementation of an integrated Cardiovascular Information System in an Acute Hospital Group

Computer based patient records have been highlighted as a requirement in modern healthcare. Evidence around their contribution to quality of care is mixed and is more reliant on how well they are implemented, with there being a bedding in period of up to one year before seeing benefits. Successful implementation leads to efficiencies, cost savings and a return on the significant financial outlay. The need for funding can be a major barrier, as are changes in work practices and people issues such as resistance. Sites with great implementation have high levels of clinician involvement, leadership with vision, resilience, flexibility and collaboration. This project outlines the plan to deliver a CVIS which will integrate across a hospital group. It has identified triggers for change and forces that might prevent it, has developed a communication plan based on a stakeholder analysis. It has created a collaborative working group, involving key stakeholders who have agreed the key priorities and essential features of the system. Important milestones are highlighted, such as addressing the funding, putting governance in place, selecting the correct vendor, having sufficient hardware, software and training in place. The project will be evaluated throughout its life cycle using a novel WHO-HOT-Fit framework. The project is an academically robust, strategic plan to implement a CVIS which will require leadership that is collaborative, honest and seeks out, and identifies people with talent and tacit knowledge who can contribute to the process