You and me and the computer makes three: Variations in exam room use of the electronic health record

Jason J. Saleem, Mindy E. Flanagan, Alissa L. Russ, Carmit K. McMullen, Leora Elli, Scott A. Russell, Katelyn J. Bennett, Marianne S. Matthias, Shakaib U. Rehman, Mark D. Schwartz, Richard M. Frankel

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Challenges persist on how to effectively integrate the electronic health record (EHR) into patient visits and clinical workflow, while maintaining patient-centered care. Our goal was to identify variations in, barriers to, and facilitators of the use of the US Department of Veterans Affairs (VA) EHR in ambulatory care workflow in order better to understand how to integrate the EHR into clinical work. We observed and interviewed 20 ambulatory care providers across three geographically distinct VA medical centers. Analysis revealed several variations in, associated barriers to, and facilitators of EHR use corresponding to different units of analysis: computer interface, team coordination/workflow, and organizational. We discuss our findings in the context of different units of analysis and connect variations in EHR use to various barriers and facilitators. Findings from this study may help inform the design of the next generation of EHRs for the VA and other healthcare systems.

Original languageEnglish (US)
Pages (from-to)e147-e151
JournalJournal of the American Medical Informatics Association
Volume21
Issue numberE2
DOIs
StatePublished - 2014

ASJC Scopus subject areas

  • Health Informatics

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    Saleem, J. J., Flanagan, M. E., Russ, A. L., McMullen, C. K., Elli, L., Russell, S. A., Bennett, K. J., Matthias, M. S., Rehman, S. U., Schwartz, M. D., & Frankel, R. M. (2014). You and me and the computer makes three: Variations in exam room use of the electronic health record. Journal of the American Medical Informatics Association, 21(E2), e147-e151. https://doi.org/10.1136/amiajnl-2013-002189