EP02.01 - Meaningful End-User Support for Meaningful EMR Use: A Scoping Review
e-Health ePoster Library. Randhawa G. Jun 7, 2016; 131546; EP02.01
Ms. Gurprit Randhawa
Ms. Gurprit Randhawa
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Abstract
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Purpose/Objectives: Although the adoption of electronic medical records (EMR) in Canada has increased to 77%, many primary care physicians (PCP) use their EMRs as 'electronic paper records' and only use the minimal or basic EMR features. The literature widely suggests that end-user support (EUS) is a critical success factor for increasing meaningful use of EMR. EUS is any information or activity that is intended to help physicians solve problems with and better utilize their EMR. However, many PCPs have to learn how to use their EMR with little effective EUS. To examine the current state of knowledge on EUS for EMRs, a scoping review was conducted to: (1) determine the extent, range, and nature of research activity on EUS for EMRs in primary care, (2) summarize the research findings on EUS; and (3) identify research gaps in the existing literature on EUS. Methodology/Approach: The scoping review was conducted using eight databases: PubMed, Compendex (Engineering Village), Web of Science, Google Scholar, Business Source Complete, CINAHL, IEEE Explore, and the Association for Information Systems's (AIS) digital library. Inclusion criteria included English language articles published before 2015. For included articles, data was extracted for country of origin, health care setting, end-user type, details of EUS during pre-implementation and post-implementation, research methodology/methods, theories, and research gaps/directions for future research. Themes from the included articles were identified. Finding/Results: A total of 4,032 articles were returned from the search. Following a review of titles and abstracts, 221 articles were identified for full-text review and secondary screening. Based on the full-text review, 90 papers were included in the scoping review. The majority of the lead authors were from the USA, and qualitative research methodology was used in most of the studies. In total, 13 themes were identified relating to EUS: (1) Inadequate Training, (2) Learning Needs, (3) Training Strategies, (4) Pre-Implementation Training, (5) Post-Implementation Training, (6) Inadequate Technical Support, (7) Champions, (8) Super-users, (9) Help-desk, (10) User Documentation, (11) EUS and EMR Use, (12) Role of End-User Supporters, and (13) Characteristics of End-User Supporters. Five areas of research gaps and future directions for research (in order of frequency): (1) Training, (2) General End-User Support, (3) Super-Users, (4) Implementation, and (5) Other Support. Conclusion/Implication/Recommendations: While there are many directions for future research on EUS identified from the scoping review, training is perceived as the largest research gap. In particular, there is a need for more research on (1) post-implementation EMR training, (2) the effects of post-implementation EMR training on meaningful use, (3) design of post-implementation EMR training interventions, and (4) efficacy of post-implementation EMR training interventions. Therefore, future research efforts should focus on addressing the research gaps surrounding post-implementation training using mixed methods methodology to increase meaningful use of EMRs in Canada. 140 Character Summary: This scoping review reveals 13 themes related to end-user support for EMR/EHR use, as well as five areas of research gaps/directions for future research.
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