Norway - Effects of the use of an EMR in Primary Care
Certain countries have had a lengthier experience with EMRs than others. Norwegian GPs began to adopt EMRs in the early 1980’s. Over 95% of Norwegian GPs have been using an EMR for the past 10 years. A study of GPs use of EMRs conducted in Norway and reported in BMC Medical Informatics and Decision Making seeks to understand the actual benefits and effects of the use of EMRs in a system in which a high uptake of EMRs tends to be looked upon as a proof of their value.
Abstract - Background:
In spite of successful adoption of electronic patient records (EPR) by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of EPR systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship.
Methods:
A combined qualitative and quantitative study that use data collected from focus groups, observations of primary care encounters and a questionnaire survey of a random sample of general practitioners to describe their use of EPR in primary care.
Results:
The overall availability of individual patient records had improved, but the availability of the information within each EPR was not satisfactory. GPs' use of EPRs were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians. We found no indications of disturbance of the clinician-patient relationship by use of computers in this study.
Conclusions:
Although GPs are generally satisfied with their EPRs systems, there are still unmet needs and functionality to be covered. It is urgent to find methods that can make a better representation of information in large patient records as well as prevent that use of EPR systems contribute to increased administrative workload for physicians.
My sense is that in order to achieve efficiencies with technology and EMRs, one needs to examine the process of care delivery at a very granular level. Once the adoption phase is over, using the EMR effectively depends on defining a specific outcome that one wants to achieve and then re-engineering the process.
Have you had experience with this process? Do you agree with the findings in this study? Does the EMR in your practice provide definite efficiencies? If so, how did you achieve those efficiencies?
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Dr. Martin Dawes of Montreal, Quebec is the winner of the first CanadianEMR survey on Non-EMR products and services which attracted 166 responses from 454 registered physicians and practice managers on CanadianEMR.ca (36% response). Dr. Dawes and his group are just in the process of implementing an EMR in their practice. He wins a Hewlett Packard Officejet J6480 All-in-One printer, copier, scanner and fax for his practice. The high response indicates the significant interest amongst physicians regarding the products and services that surround and support an EMR-based practice.
In a very interesting issue of Future Practice (published by the Canadian Medical Association), a number of important issues are discussed that provide insight in the world of EMR and IT adoption and use in clinical practice settings.
Human, Social, and Organizational Aspects of Health Information Systems offers an evidence-based management approach to issues associated with the human and social aspects of designing, developing, implementing, and maintaining health information systems across a healthcare organization—specific to an individual, team, organizational, system, and international perspective. Integrating knowledge from multiple levels, this book will benefit scholars and practitioners from the medical information, health service management, and information technology arenas.
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