Allied health clinician experiences of electronic medical record implementation and the impact on allied health workflow: An observational study

Kath Feely1,2,4,5, Dr Lara Edbrooke2,3, A/Prof Wendy Bower1,3, Sandra  Mazzone4, Dr Mark Merolli3, Julia Staples5, A/Prof Alicia Martin2

1The Royal Melbourne Hospital, Parkville, Australia, 2Peter Mac Callum Cancer Centre, Parkville, Australia, 3The University of Melbourne, Parkville, Australia, 4Royal Women’s Hospital, Parkville, Australia, 5Royal Children’s Hospital, Parkville, Australia

Background: There is limited evidence describing the impact of largescale electronic medical record (EMR) implementation on allied health (AH) clinicians’ acceptance, expectations and work efficiencies.

Aims: To identify factors that influence EMR adoption and evaluate impact of a “big bang” implementation on AH workflow at three tertiary hospitals.

Methods: Repeated measures study pre and six months post-EMR implementation.  User acceptance was evaluated with online surveys: Unified Theory of Acceptance and Use of Technology (pre) and System Usability Scale (post).  A 4-hour time-motion study evaluated inpatient workflows.

Results: Surveys were completed by 224 clinicians (47% response rate) pre, and 196 (41%) post. Before implementation 41% respondents felt apprehensive and 29% somewhat intimidated about using EMR.  After 6 months 88% liked using EMR frequently and found it easy to use (64%) without technical support (78%).  While 68% felt very confident, 51% believed they were not utilising EMR’s full potential.

Half of AH clinicians agreed that significant upskilling is required and that it is not quick to learn.  Live demonstrations were most valuable prior to training; hands-on practice in trainplay and superuser support were most valuable preparations for and during “go-live”.

Time-motion 4-hour data indicated that AH participants spent significantly more time in ‘direct clinical intervention’ after implementation (median (IQR)) 1.5 hours (1.0, 2.0) compared to 1.2 hours (0.8, 1.7) pre EMR, p=0.04.

Conclusions: Many factors can positively impact allied health adoption of a new EMR.  “Big bang” implementation can lead to AH workflow efficiencies that increase time spent providing clinical intervention.


Biography:

Kath Feely has worked in Public Health in Victoria for more than 20 years as a physiotherapist.  She is the Chief Allied Health Information Officer at Parkville Precinct and co-chair of the Victorian Allied Health Clinical Informatics Advisory Group. Kath is passionate about using technology and data to evaluate and improve clinical service delivery and patient outcomes.

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