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Monica Michelotti, Jennifer Weizer, Taylor Blachley, Kai Zheng, Mick Couper, Grant Greenberg, Sharon Kileny, Greta Branford, David Hanauer; Ophthalmologists’ Attitudes on Implementing an Electronic Health Record System. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4425.
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The practice of ophthalmology has documentation requirements that differ from other medical fields. Many health systems are adopting electronic health records (EHR) systems designed for general or subspecialty medicine or surgery that are not highly tailored for ophthalmology. As most practices will soon be required to use EHRs in the United States to meet meaningful use objectives, thousands of ophthalmologists will need to change their documentation process. The goal of this initiative was to determine the attitudes of ophthalmologists at a large academic institution before and after the implementation of a popular commercial EHR system.
A prospective survey was sent to 59 faculty ophthalmologists one month prior to implementing a new EHR system at the University of Michigan. The ophthalmologists were transitioning from primarily paper charting. The survey asked 29 questions focused on satisfaction with the prior system, training experience, practice style, and expectations about the new EHR. Three months after implementation, a follow-up survey was sent to all participants. The findings from both surveys were compared using Fisher exact tests.
32 of 59 ophthalmologists (54%) completed the pre-implementation survey compared to 28 of 59 (47%) post-implementation. Job satisfaction scores (p=0.0022) and time spent completing charts in the evening (p=0.0072) were significantly different, with fewer physicians satisfied and more physicians charting in the evening post-implementation. Comparing prior paper charting with EHRs, ophthalmologists as a group reported no significant differences in: their ability to create high quality documentation, interact with patients in a meaningful way, or document information in a timely fashion. EHR implementation did not significantly affect ophthalmologists’ perception of efficiency and workflow. Fifty percent of respondents expressed at least some degree of concern about the EHR system both prior to and after implementation. Overall more ophthalmologists preferred to keep the EHR instead of returning to paper charting.
As ophthalmology practices rapidly transition to EHRs, tailoring the EHR programs to best fit their needs, and measuring the impact these systems have on quality of care and user satisfaction, will become even more crucial.
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