Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework
Abstract Background Recent decades have seen rapid growth in the implementation of Electronic Medical Records (EMRs) in healthcare settings in both developed regions as well as low and middle income countries. Yet despite substantial investment, the implementation of EMRs in some primary care system...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Medical Informatics and Decision Making |
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| Online Access: | http://link.springer.com/article/10.1186/s12911-018-0703-x |
| _version_ | 1811287486114037760 |
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| author | Amy O’Donnell Eileen Kaner Caroline Shaw Catherine Haighton |
| author_facet | Amy O’Donnell Eileen Kaner Caroline Shaw Catherine Haighton |
| author_sort | Amy O’Donnell |
| collection | DOAJ |
| description | Abstract Background Recent decades have seen rapid growth in the implementation of Electronic Medical Records (EMRs) in healthcare settings in both developed regions as well as low and middle income countries. Yet despite substantial investment, the implementation of EMRs in some primary care systems has lagged behind other settings, with piecemeal adoption of EMR functionality by primary care physicians (PCPs) themselves. We aimed to review and synthesise international literature on the attitudes of PCPs to EMR adoption using the Clinical Adoption (CA) Framework. Methods MEDLINE, PsycINFO, and EMBASE were searched from 1st January 1996 to 1st August 2017 for studies investigating PCP attitudes towards EMR adoption. Papers were screened by two independent reviewers, and eligible studies selected for further assessment. Findings were categorised against the CA Framework and the quality of studies assessed against one of three appropriate tools. Results Out of 2263 potential articles, 33 were included, based in North and South America, Europe, Middle East and Hong Kong. Concerns about the accessibility, reliability and EMR utility exerted an adverse influence on PCPs’ attitudes to adoption. However many were positive about their potential to improve clinical productivity, patient safety and care quality. Younger, computer-literate PCPs, based in large/multi-group practices, were more likely to be positively inclined to EMR use than older physicians, less-skilled in technology use, based in solo practices. Adequate training, policies and procedures favourably impacted on PCPs’ views on EMR implementation. Financial factors were common system level influencers shaping EMR adoption, from start-up costs to the resources required by ongoing use. Conclusions By using the CA Framework to synthesise the evidence, we identified a linked series of factors influencing PCPs attitudes to EMR adoption. Findings underline the need to involve end-users in future implementation programmes from the outset, to avoid the development of an EMR which is neither feasible nor acceptable for use in practice. Trial registration PROSPERO CRD42016038790. |
| first_indexed | 2024-04-13T03:19:21Z |
| format | Article |
| id | doaj.art-336960cd2b474b2bb43c60b70f06eb4c |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-04-13T03:19:21Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-336960cd2b474b2bb43c60b70f06eb4c2022-12-22T03:04:49ZengBMCBMC Medical Informatics and Decision Making1472-69472018-11-0118111610.1186/s12911-018-0703-xPrimary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption frameworkAmy O’Donnell0Eileen Kaner1Caroline Shaw2Catherine Haighton3Institute of Health & Society, Newcastle UniversityInstitute of Health & Society, Newcastle UniversityInstitute of Health & Society, Newcastle UniversityDepartment of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria UniversityAbstract Background Recent decades have seen rapid growth in the implementation of Electronic Medical Records (EMRs) in healthcare settings in both developed regions as well as low and middle income countries. Yet despite substantial investment, the implementation of EMRs in some primary care systems has lagged behind other settings, with piecemeal adoption of EMR functionality by primary care physicians (PCPs) themselves. We aimed to review and synthesise international literature on the attitudes of PCPs to EMR adoption using the Clinical Adoption (CA) Framework. Methods MEDLINE, PsycINFO, and EMBASE were searched from 1st January 1996 to 1st August 2017 for studies investigating PCP attitudes towards EMR adoption. Papers were screened by two independent reviewers, and eligible studies selected for further assessment. Findings were categorised against the CA Framework and the quality of studies assessed against one of three appropriate tools. Results Out of 2263 potential articles, 33 were included, based in North and South America, Europe, Middle East and Hong Kong. Concerns about the accessibility, reliability and EMR utility exerted an adverse influence on PCPs’ attitudes to adoption. However many were positive about their potential to improve clinical productivity, patient safety and care quality. Younger, computer-literate PCPs, based in large/multi-group practices, were more likely to be positively inclined to EMR use than older physicians, less-skilled in technology use, based in solo practices. Adequate training, policies and procedures favourably impacted on PCPs’ views on EMR implementation. Financial factors were common system level influencers shaping EMR adoption, from start-up costs to the resources required by ongoing use. Conclusions By using the CA Framework to synthesise the evidence, we identified a linked series of factors influencing PCPs attitudes to EMR adoption. Findings underline the need to involve end-users in future implementation programmes from the outset, to avoid the development of an EMR which is neither feasible nor acceptable for use in practice. Trial registration PROSPERO CRD42016038790.http://link.springer.com/article/10.1186/s12911-018-0703-xElectronic health recordsPrimary health careGeneral practitionersClinical adoption framework |
| spellingShingle | Amy O’Donnell Eileen Kaner Caroline Shaw Catherine Haighton Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework BMC Medical Informatics and Decision Making Electronic health records Primary health care General practitioners Clinical adoption framework |
| title | Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework |
| title_full | Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework |
| title_fullStr | Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework |
| title_full_unstemmed | Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework |
| title_short | Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework |
| title_sort | primary care physicians attitudes to the adoption of electronic medical records a systematic review and evidence synthesis using the clinical adoption framework |
| topic | Electronic health records Primary health care General practitioners Clinical adoption framework |
| url | http://link.springer.com/article/10.1186/s12911-018-0703-x |
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