Trends in Primary Care Clinician Perceptions of a New Electronic Health Record

Background  Clinician perceptions of a newly implemented electronic health record play an important role in its success or failure. Objective  To measure changes in primary care clinician attitudes toward an electronic health record during the first year following implementation. Design  Longitudinal survey. Participants  86 primary care clinicians surveyed between December 2006 and January 2008. Measurements  Perceived impact on overall quality of care, patient safety, communication, and efficiency at 1, 3, 6, and 12 months following implementation. Results  Response rates for months 1, 3, 6, and 12 were 92%, 95%, 90%, and 82%, respectively. The proportion of clinicians agreeing that the EHR improved the overall quality of care (63% to 86%; p < 0.001), reduced medication-related errors (72% to 81%; p = 0.03), improved follow-up of test results (62% to 87%; p < 0.001), and improved communication among clinicians (72% to 93%; p < 0.001) increased from month 1 to month 12. During the same time period, a decreasing proportion of clinicians agreed that the EHR reduced the quality of patient interactions (49% to 33%; p = 0.001), resulted in longer patient visits (68% to 51%; p = 0.001), and increased time spent on medical documentation (78% to 68%; p = 0.006). Significant improvements in perceptions related to test result follow-up were first detected at 6 months, while those related to overall quality, efficiency, and communication were first identified at 12 months. Conclusions  Primary care clinicians report increasingly positive perceptions of a new electronic health record within 1 year of implementation across a spectrum of domains of care. This study was funded by grants from the Agency for Healthcare Research and Quality (1 R01 HS 015226-01) and the National Library of Medicine (2 T15 LM 07092-16).