Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review.
Electronic health records
General practitioners
Primary health care
Journal
BMC medical informatics and decision making
ISSN: 1472-6947
Titre abrégé: BMC Med Inform Decis Mak
Pays: England
ID NLM: 101088682
Informations de publication
Date de publication:
19 02 2021
19 02 2021
Historique:
received:
03
07
2020
accepted:
09
02
2021
entrez:
20
2
2021
pubmed:
21
2
2021
medline:
24
4
2021
Statut:
epublish
Résumé
Despite a substantial increase in the adoption of electronic medical records (EMRs) in primary health care settings, the use of advanced EMR features is limited. Several studies have identified both barriers and facilitating factors that influence primary care physicians' (PCPs) use of advanced EMR features and the maturation of their EMR use. The purpose of this study is to explore and identify the factors that impact PCPs' mature use of EMRs. A systematic review was conducted in accordance with the Cochrane Handbook. The MEDLINE, Embase, and PsycINFO electronic databases were searched from 1946 to June 13, 2019. Two independent reviewers screened the studies for eligibility; to be included, studies had to address factors influencing PCPs' mature use of EMRs. A narrative synthesis was conducted to collate study findings and to report on patterns identified across studies. The quality of the studies was also appraised. Of the 1893 studies identified, 14 were included in this study. Reported factors that influenced PCPs' mature use of EMRs fell into one of the following 5 categories: technology, people, organization, resources, and policy. Concerns about the EMR system's functionality, lack of physician awareness of EMR functionality, limited physician availability to learn more about EMRs, the habitual use of successfully completing clinical tasks using only basic EMR features, business-oriented organizational objectives, lack of vendor training, limited resource availability, and lack of physician readiness were reported as barriers to PCPs' mature use of EMRs. The motivation of physicians, user satisfaction, coaching and peer mentoring, EMR experience, gender, physician perception, transition planning for changes in roles and work processes, team-based care, adequate technical support and training, sharing resources, practices affiliated with an integrated delivery system, financial incentives, and policies to increase EMR use all had a favorable impact on PCPs' use of advanced EMR features. By using a narrative synthesis to synthesize the evidence, we identified interrelated factors influencing the mature use of EMRs by PCPs. The findings underline the need to provide adequate training and policies that facilitate the mature use of EMRs by PCPs. PROSPERO CRD42019137526.
Sections du résumé
BACKGROUND
Despite a substantial increase in the adoption of electronic medical records (EMRs) in primary health care settings, the use of advanced EMR features is limited. Several studies have identified both barriers and facilitating factors that influence primary care physicians' (PCPs) use of advanced EMR features and the maturation of their EMR use. The purpose of this study is to explore and identify the factors that impact PCPs' mature use of EMRs.
METHODS
A systematic review was conducted in accordance with the Cochrane Handbook. The MEDLINE, Embase, and PsycINFO electronic databases were searched from 1946 to June 13, 2019. Two independent reviewers screened the studies for eligibility; to be included, studies had to address factors influencing PCPs' mature use of EMRs. A narrative synthesis was conducted to collate study findings and to report on patterns identified across studies. The quality of the studies was also appraised.
RESULTS
Of the 1893 studies identified, 14 were included in this study. Reported factors that influenced PCPs' mature use of EMRs fell into one of the following 5 categories: technology, people, organization, resources, and policy. Concerns about the EMR system's functionality, lack of physician awareness of EMR functionality, limited physician availability to learn more about EMRs, the habitual use of successfully completing clinical tasks using only basic EMR features, business-oriented organizational objectives, lack of vendor training, limited resource availability, and lack of physician readiness were reported as barriers to PCPs' mature use of EMRs. The motivation of physicians, user satisfaction, coaching and peer mentoring, EMR experience, gender, physician perception, transition planning for changes in roles and work processes, team-based care, adequate technical support and training, sharing resources, practices affiliated with an integrated delivery system, financial incentives, and policies to increase EMR use all had a favorable impact on PCPs' use of advanced EMR features.
CONCLUSIONS
By using a narrative synthesis to synthesize the evidence, we identified interrelated factors influencing the mature use of EMRs by PCPs. The findings underline the need to provide adequate training and policies that facilitate the mature use of EMRs by PCPs.
TRIAL REGISTRATION
PROSPERO CRD42019137526.
Identifiants
pubmed: 33607986
doi: 10.1186/s12911-021-01434-9
pii: 10.1186/s12911-021-01434-9
pmc: PMC7893965
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
67Références
Am J Manag Care. 2012 Feb 01;18(2):e48-54
pubmed: 22435884
Implement Sci. 2018 Jan 25;13(Suppl 1):13
pubmed: 29384081
BMJ. 2015 Jan 02;350:g7647
pubmed: 25555855
Health Aff (Millwood). 2008 May-Jun;27(3):759-69
pubmed: 18474969
Healthc Inform Res. 2015 Jul;21(3):152-60
pubmed: 26279951
Health Aff (Millwood). 2015 Dec;34(12):2104-12
pubmed: 26643631
Implement Sci. 2018 Jan 25;13(Suppl 1):10
pubmed: 29384082
BMJ Health Care Inform. 2019 Sep;26(1):
pubmed: 31570365
Ann Intern Med. 2013 Jun 4;158(11):791-9
pubmed: 23732712
Med Care. 2014 Feb;52(2):144-8
pubmed: 24309669
Int J Med Inform. 2015 Oct;84(10):857-67
pubmed: 26238705
Implement Sci. 2018 Jan 25;13(Suppl 1):4
pubmed: 29384080
JMIR Hum Factors. 2018 Dec 21;5(4):e30
pubmed: 30578203
Implement Sci. 2018 Jan 25;13(Suppl 1):9
pubmed: 29384078
Health Serv Res. 2014 Feb;49(1 Pt 2):421-37
pubmed: 24359032
Stud Health Technol Inform. 2007;129(Pt 1):616-20
pubmed: 17911790
Ann Fam Med. 2009 Jul-Aug;7(4):309-18
pubmed: 19597168
Int J Med Inform. 2009 Jan;78(1):22-31
pubmed: 18644745
BMC Med Inform Decis Mak. 2012 Feb 24;12:10
pubmed: 22364529
BMJ. 2002 Mar 2;324(7336):524-9
pubmed: 11872553
Oral Health Dent Manag. 2013 Mar;12(1):9-16
pubmed: 23474576
Implement Sci. 2018 Jan 25;13(Suppl 1):14
pubmed: 29384077
Fam Pract. 2018 Sep 18;35(5):607-611
pubmed: 29444228
J Am Board Fam Med. 2015 Sep-Oct;28 Suppl 1:S63-72
pubmed: 26359473
BMJ. 2017 Sep 21;358:j4008
pubmed: 28935701
Ann Fam Med. 2011 Mar-Apr;9(2):165-71
pubmed: 21403144
BMJ Open. 2013 Sep 13;3(9):e003610
pubmed: 24038011
Health Informatics J. 2017 Apr 1;:1460458217704244
pubmed: 28434279
Implement Sci. 2018 Jan 25;13(Suppl 1):2
pubmed: 29384079
Appl Clin Inform. 2018 Jan;9(1):15-33
pubmed: 29320797
Can Fam Physician. 2013 Jul;59(7):e322-9
pubmed: 23851560
Health Aff (Millwood). 2012 Dec;31(12):2805-16
pubmed: 23154997
N Engl J Med. 2013 Feb 21;368(8):779-80
pubmed: 23425186
BMC Health Serv Res. 2010 Aug 06;10:231
pubmed: 20691097
BMC Med Res Methodol. 2009 Aug 11;9:59
pubmed: 19671152
BMC Med Inform Decis Mak. 2015 Apr 14;15:27
pubmed: 25888991
JMIR Hum Factors. 2016 Feb 15;3(1):e9
pubmed: 27025237
Health Serv Res. 2014 Feb;49(1 Pt 2):347-60
pubmed: 24358958
JMIR Med Inform. 2019 Nov 29;7(4):e13318
pubmed: 31782742
BMC Med Inform Decis Mak. 2014 May 29;14:43
pubmed: 24884588
BMC Med Inform Decis Mak. 2010 Oct 15;10:60
pubmed: 20950458
J Eval Clin Pract. 2014 Feb;20(1):36-42
pubmed: 23962319
J Gen Intern Med. 2009 Mar;24(3):341-8
pubmed: 19130148
BMC Med Inform Decis Mak. 2017 Apr 20;17(1):46
pubmed: 28427405
JAMA. 1995 Jan 18;273(3):192
pubmed: 7807653