Instant availability of patient records, but diminished availability of patient information: a multi-method study of GP's use of electronic patient records

Abstract

Background: In spite of successful adoption of electronic patient records (EPR) by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR) systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship.

Methods: A combined qualitative and quantitative study that uses data collected from focus groups, observations of primary care encounters and a questionnaire survey of a random sample of general practitioners to describe their use of EPR in primary care.

Results: The overall availability of individual patient records had improved, but the availability of the information within each EPR was not satisfactory. GPs' use of EPRs were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians. We found no indications of disturbance of the clinician-patient relationship by use of computers in this study.

Conclusion: Although GPs are generally satisfied with their EPRs systems, there are still unmet needs and functionality to be covered. It is urgent to find methods that can make a better representation of information in large patient records as well as prevent EPRs from contributing to increased administrative workload of physicians.

Figure 1

Time spent to document in EPR. Differences in time spent to document during an encounter registered in the observation study (No 14) and the questionnaire study (No = 227).

Figure 2

Length of the encounter. Distribution of the length of the encounter reported by GPs in the questionnaire study (No = 227).

Figure 3

Length of encounters and time spent to document in the EPR. Reported by GPs in the questionnaire study (No = 222). One encounter lasting less than 10 minutes and one encounter with documentation time less than one minute were left out from the figure.