Doctors' use of electronic medical records systems in hospitals: cross sectional survey

Abstract

Objectives: To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks.

Design: Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems.

Setting: 32 hospital units in 19 Norwegian hospitals with electronic medical records systems.

Participants: 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems.

Main outcome measures: Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar.

Results: Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems.

Conclusions: Doctors used electronic medical records systems for far fewer tasks than the systems supported.

Figure 1

Reported use of computer programs for various clinical tasks by doctors from hospitals with different electronic medical records systems. Bars represent percentage of doctors who reported using computers at least half of the time for performing each task (red areas show those who used only the electronic medical records system, white areas show those who used the system and other software, and orange areas show those who did not state what program they used) and error bars show the confidence interval. Pink bars in background show percentage of respondents for whom the electronic medical records systems offered sufficient functionality for the task

Figure 2

Clinical tasks for which significantly different percentages of doctors reported using three different electronic medical records systems that offered equivalent functionality. Bars represent percentage of doctors who reported using computers at least half of the time for performing each task (red areas show those who used only the electronic medical records system, white areas show those who used the system and other software, and orangeareas show those who did not state what program they used) and error bars show the confidence interval. P values were calculated with χ² formula (equal P values wereachieved with analysis of red areas of bars only and when white and orange areas were included).