Medical Specialists' Perspectives on the Influence of Electronic Medical Record Use on the Quality of Hospital Care:Semistructured Interview Study

Objective: The aim of this study was to examine how, and by which aspects, the relationship between EMR use and the qualityof care in hospitals is influenced according to medical specialists.Methods: To answer this question, a qualitative study was conducted in the period of August-October 2018. Semistructuredinterviews of around 90 min were conducted with 11 medical specialists from 11 different Dutch hospitals. For analysis of theanswers, we used a previously published taxonomy of factors that can influence the use of EMRs.Results: The professional experience of the participating medical specialists varied between 5 and 27 years. Using the previouslypublished taxonomy, these medical specialists considered technical barriers the most significant for EMR use. The suboptimalchange processes surrounding implementation were also perceived as a major barrier. A final major problem is related to thecategories “social” (their relationships with the patients and fellow care providers), “psychological” (based on their personalissues, knowledge, and perceptions), and “time” (the time required to select, implement, and learn how to use EMR systems andsubsequently enter data into the system). However, the medical specialists also identified potential technical facilitators, particularlyin the assured availability of information to all health care professionals involved in the care of a patient. They see promise inusing EMRs for medical decision support to improve the quality of care but consider these possibilities currently lacking.Conclusions: The 11 medical specialists shared positive experiences with EMR use when comparing it to formerly used paperrecords. The fact that involved health care professionals can access patient data at any time they need is considered important.However, in practice, potential quality improvement lags as long as decision support cannot be applied because of the lack of afully coded patient record