The Role of Provider Perceptions in Deploying an Electronic Medical Record at Michigan State University

The Role of Provider Perceptions in Deploying an EMR at Michigan State University Pamela Whitten, PhD Lorraine Buis, PhD Michigan State University Michael Mackert, PhD University of Texas at Austin EMRs     The potential for EMRs has been recognized since the 1960’s Benefits include cost savings, reduced medical errors, and improved quality and continuity of care Despite benefits, adoption has been slow Structural and organizational issues have been cited as barriers to adoption Purpose   To understand the role and impact of individual and organizational issues on perceptions regarding EMRs by physicians at Michigan State University (MSU). This investigation sought to identify: Perceptions of the general impacts of EMRs  Initial and current attitudes toward EMR adoption  Perceptions of the success and impacts MSUs EMR Relationships between demographic or experiential variables and perceptions of the EMR system  Methods  41 providers from MSU HealthTeam Gender: 66% male and 34% female  Age: 41% were 35 – 50 and 51% were 50+  Computer Skills: 56% rate skills and high and none report skills “below average”   MSU EMR rollout Survey Instrument  144 item survey Based on Lærum, Ellingsen, and Faxvaag (2001)  Approximately 30 minute completion time  Descriptive statistics were employed to understand perceptions of EMRs in general and at MSU  Results   Providers report positive perceptions of the general impacts of EMRs Majority believe EMRs have or will have a beneficial impact on: Access to healthcare in rural areas (83%)  Clinicians’ access to up to date knowledge (80%)  Quality of healthcare (71%)  Interactions within the health team (68%)  Continuing medical education (68%)  Results  Providers report mixed perceptions regarding adoption and overall success of the system at MSU 45% favored adoption initially and still consider it a good choice  11% didn’t initially favor adoption, but now consider it a good choice  34% initially favored adoption, but now consider it a bad choice  11% initially opposed the adoption and still consider it a bad choice  Results  Ratings of EMR success at MSU were mixed 27% rating as good or excellent  56% rating as fair  17% rating as poor   Ratings of EMR satisfaction at MSU were mixed 37% rating as good or excellent  34% rating as fair  29% rating as poor  Results  No demographic variables were consistently related to perceptions of the success and satisfaction of the EMR system at MSU. Age was found to be negatively correlated with the perceived satisfaction of the EMR system at MSU  (r = -.401, p<.05)  Results   Several measures of the perception of potential impacts of EMRs on healthcare were related to success and satisfaction Particularly, beliefs that EMRs have impacts on: Quality of healthcare  Enjoyment on the practice of medicine  Interactions within the health team  Rapport between clinicians and patients  Clinician autonomy  Results Satisfaction with EMR System at MSU System had Changed the Ease of Performing Departmental Work r = .423 r = .420 r = .505 r = .405 r = .326 System has Changed the Quality of Departmental Work Success of the EMR System at MSU Impact of EMRs on the Quality of Healthcare Impact of EMRs on the Enjoyment of the Practice of Medicine Impact of EMRs on the Interaction within the Health Team Impact of EMRs on the Rapport between Clinicians and Patients Impact of EMRs on Clinician Autonomy r = .497 r = .451 r = .521 r = .478 r = .346 r = .519 r = .424 r = .399 r = .499 r = .400 Discussion    Mixed feelings toward adoption indicates a need to involve users in decision making to increase buy-in Perceptions of the impacts of EMRs have greater impact on success and satisfaction than demographics Speaks to the need to increase EMR education