In a very interesting study published in BMC Medical Informatics and Decision Making in March 2008, the impact of electronic medical records by Norwegian GPs highlighted some of the gaps in terms of the way that information is presented in EMRs (or EPRs as referred to in the article). The study identified that there was a transfer of administrative work from the medical office staff to the physician, but did not interfere with the physician patient relationship.
A very interesting observation was the fact that the physician's perception of the time spent documenting information in the EMR system (measured by questionnaire) was significantly longer than that measured through a concommitant observational study. The study demonstrated that 79% of physicians were able to document the patient encounter within 3 minutes whereas 51% of physician's believed they had spent 4-5 minutes documenting the patient encounter and 18% over 6 minutes documenting the encounter. The evidence does not support this perception.
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.
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