Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study
Abstract Background In the era of electronic health records (EHR), the ability to share clinical data is a key facilitator of healthcare delivery. Since the introduction of EHRs, this aspect has been extensively studied from the perspective of healthcare providers. Less often explored are the day-to...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12911-023-02255-8 |
| _version_ | 1797559296283639808 |
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| author | Edmond Li Olivia Lounsbury Jonathan Clarke Hutan Ashrafian Ara Darzi Ana Luisa Neves |
| author_facet | Edmond Li Olivia Lounsbury Jonathan Clarke Hutan Ashrafian Ara Darzi Ana Luisa Neves |
| author_sort | Edmond Li |
| collection | DOAJ |
| description | Abstract Background In the era of electronic health records (EHR), the ability to share clinical data is a key facilitator of healthcare delivery. Since the introduction of EHRs, this aspect has been extensively studied from the perspective of healthcare providers. Less often explored are the day-to-day challenges surrounding the procurement, deployment, maintenance, and use of interoperable EHR systems, from the perspective of healthcare administrators, such as chief clinical information officers (CCIOs). Objective Our study aims to capture the perceptions of CCIOs on the current state of EHR interoperability in the NHS, its impact on patient safety, the perceived facilitators and barriers to improving EHR interoperability, and what the future of EHR development in the NHS may entail. Methods Semi-structured interviews were conducted between November 2020 – October 2021. Convenience sampling was employed to recruit NHS England CCIOs. Interviews were digitally recorded and transcribed verbatim. A thematic analysis was performed by two independent researchers to identify emerging themes. Results Fifteen CCIOs participated in the study. Participants reported that limited EHR interoperability contributed to the inability to easily access and transfer data into a unified source, thus resulting in data fragmentation. The resulting lack of clarity on patients' health status negatively impacts patient safety through suboptimal care coordination, duplication of efforts, and more defensive practice. Facilitators to improving interoperability included the recognition of the need by clinicians, patient expectations, and the inherent centralised nature of the NHS. Barriers included systems usability difficulties, and institutional, data management, and financial-related challenges. Looking ahead, participants acknowledged that realising that vision across the NHS would require a renewed focus on mandating data standards, user-centred design, greater patient involvement, and encouraging inter-organisational collaboration. Conclusion Tackling poor interoperability will require solutions both at the technical level and in the wider policy context. This will involve demanding interoperability functionalities from the outset in procurement contracts, fostering greater inter-organisation cooperation on implementation strategies, and encouraging systems vendors to prioritise interoperability in their products. Only by comprehensively addressing these challenges would the full potential promised by the use of fully interoperable EHRs be realised. |
| first_indexed | 2024-03-10T17:43:19Z |
| format | Article |
| id | doaj.art-f548b41ef7cb46a4a586a993176d43b1 |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-03-10T17:43:19Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-f548b41ef7cb46a4a586a993176d43b12023-11-20T09:38:31ZengBMCBMC Medical Informatics and Decision Making1472-69472023-08-0123111510.1186/s12911-023-02255-8Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview studyEdmond Li0Olivia Lounsbury1Jonathan Clarke2Hutan Ashrafian3Ara Darzi4Ana Luisa Neves5Institute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College LondonJohns Hopkins Children’s CenterInstitute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College LondonInstitute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College LondonInstitute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College LondonInstitute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College LondonAbstract Background In the era of electronic health records (EHR), the ability to share clinical data is a key facilitator of healthcare delivery. Since the introduction of EHRs, this aspect has been extensively studied from the perspective of healthcare providers. Less often explored are the day-to-day challenges surrounding the procurement, deployment, maintenance, and use of interoperable EHR systems, from the perspective of healthcare administrators, such as chief clinical information officers (CCIOs). Objective Our study aims to capture the perceptions of CCIOs on the current state of EHR interoperability in the NHS, its impact on patient safety, the perceived facilitators and barriers to improving EHR interoperability, and what the future of EHR development in the NHS may entail. Methods Semi-structured interviews were conducted between November 2020 – October 2021. Convenience sampling was employed to recruit NHS England CCIOs. Interviews were digitally recorded and transcribed verbatim. A thematic analysis was performed by two independent researchers to identify emerging themes. Results Fifteen CCIOs participated in the study. Participants reported that limited EHR interoperability contributed to the inability to easily access and transfer data into a unified source, thus resulting in data fragmentation. The resulting lack of clarity on patients' health status negatively impacts patient safety through suboptimal care coordination, duplication of efforts, and more defensive practice. Facilitators to improving interoperability included the recognition of the need by clinicians, patient expectations, and the inherent centralised nature of the NHS. Barriers included systems usability difficulties, and institutional, data management, and financial-related challenges. Looking ahead, participants acknowledged that realising that vision across the NHS would require a renewed focus on mandating data standards, user-centred design, greater patient involvement, and encouraging inter-organisational collaboration. Conclusion Tackling poor interoperability will require solutions both at the technical level and in the wider policy context. This will involve demanding interoperability functionalities from the outset in procurement contracts, fostering greater inter-organisation cooperation on implementation strategies, and encouraging systems vendors to prioritise interoperability in their products. Only by comprehensively addressing these challenges would the full potential promised by the use of fully interoperable EHRs be realised.https://doi.org/10.1186/s12911-023-02255-8Electronic health recordsInteroperabilityPatient safetyHealth ITHealth policyQualitative research |
| spellingShingle | Edmond Li Olivia Lounsbury Jonathan Clarke Hutan Ashrafian Ara Darzi Ana Luisa Neves Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study BMC Medical Informatics and Decision Making Electronic health records Interoperability Patient safety Health IT Health policy Qualitative research |
| title | Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study |
| title_full | Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study |
| title_fullStr | Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study |
| title_full_unstemmed | Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study |
| title_short | Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study |
| title_sort | perceptions of chief clinical information officers on the state of electronic health records systems interoperability in nhs england a qualitative interview study |
| topic | Electronic health records Interoperability Patient safety Health IT Health policy Qualitative research |
| url | https://doi.org/10.1186/s12911-023-02255-8 |
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