JMIR Publications

ABSTRACT

Background:

The effect electronic health record (EHR) implementation has on physician satisfaction and patient care remains unclear. A better understanding of physicians’ perceptions of EHR’s and factors that influence those perceptions is needed to improve the physician and patient experience when using EHR’s.

Objective:

The objective of this study was to determine provider and clinical practice factors associated with physicians’ EHR satisfaction and perception of patient impact.

Methods:

We surveyed a random sample of physicians, including residents and fellows, at a quaternary care academic hospital from February to March 2016. The survey assessed provider demographics, clinical practice factors, and overall EHR experience. The primary outcomes assessed were providers’ satisfaction and the providers’ perception of impact to patient care. Responses on the satisfaction and patient impact questions were recorded on a continuous scale initially anchored at neutral (scale range 0-100 with 0 defined as extremely negatively and 100 as extremely positively). Independent variables assessed included demographic and clinical practice factors including perceived efficiency in using the EHR. One-way analysis of variance or the Kruskal-Wallis Test was used for bivariate comparisons and linear regression was used for multivariable modeling.

Results:

111 of 157 physicians (71%) completed the survey. 51% of the respondents were attending physicians, and of those, 72% reported a > 50% clinical FTE and half reported supervising residents >50% of the time. 36% of the respondents were primary care practitioners and previous EHR experience was evenly distributed. 13% of the total sample were EHR super users. Responses to how our current EHR affects satisfaction were rated above the neutral survey anchor point (mean=58, std. dev 22) as were their perceptions as to how the EHR impacts the patient (mean=61, std. dev 18). In bivariate comparisons, only physician age, clinical role (resident, fellow, or attending), and perceived efficiency were associated with EHR satisfaction. In the linear regression models, physicians with higher reported perceived efficiency reported higher overall satisfaction and patient impact after controlling for other variables in the model.

Conclusions:

Physician satisfaction with EHRs and their perception of its impact on clinical care were generally positive but physician characteristics, greater age and attending physician, were associated with worse EHR satisfaction. Perceived efficiency is the factor most associated with physicians’ satisfaction with EHRs when controlling for other factors. Understanding physician perceptions of EHRs may allow targeting of technology resources to ensure efficiency and satisfaction with EHR system use during clinical care.