Evidence map›Paper›PMID 37798579›Full record

ArticleJournal of general internal medicine2023

From "Local Control" to "Dependency": Transitions to Single-Vendor Integrated Electronic Health Record Systems and Their Implications for the EHR Workforce.

Julian Brunner, Ekaterina Anderson, David C Mohr, Adena Cohen-Bearak, Seppo T Rinne

Open access · hybridAbstract read
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Julian BrunnerCenter for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA. julian.brunner@va.gov.ORCID 0000-0002-0878-5178
Ekaterina AndersonCenter for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA.
David C MohrCenter for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.
Adena Cohen-BearakCenter for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA.
Seppo T RinneCenter for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA.
Boston University · USCenter for the Study of Healthcare Provider Behavior · USUniversity of Massachusetts Chan Medical School · USVA New England Healthcare System · US

Funding

HSRD VA IK2 HX002248
6 · The paper itself

Abstract

backgroundHealthcare systems that previously used either a single legacy electronic health record (EHR) system or a "best-of-breed" combination of products from multiple vendors are increasingly adopting integrated, single-vendor EHR systems. Though healthcare leaders are beginning to recognize the dramatic collateral consequences of these transitions, their impact on the EHR workforce - internal actors most closely involved in governing and supporting the EHR - is poorly understood.

objectiveIdentify perceived impacts of adopting single-vendor, integrated EHR systems on the institutional EHR workforce.

designIn this qualitative study, we conducted semi-structured phone interviews in four healthcare systems in the USA that had adopted an integrated EHR within the previous five years.

participantsForty-two staff members of four geographically and organizationally diverse healthcare systems, including 22 individuals with formal informatics roles. APPROACH: Transcribed interviews were coded and analyzed using qualitative content analysis methods. KEY

resultsAcross organizations, participants described a loss of autonomy by the EHR workforce at the individual and institutional level following the adoption of an integrated EHR. We also identified references to transformations in four key professional functions of the EHR workforce: communication, governance, optimization, and education.

conclusionsTransitions to integrated EHR systems can have important implications for the autonomy and professional functions of the EHR workforce. These findings may help institutions embarking on similar transitions better anticipate and prepare for these changes through such practices as revising job descriptions, strengthening EHR governance structures, and reinforcing pathways to engage frontline clinicians in supporting the EHR. Findings may also help institutions structure vendor contracts in a way that anticipates and mitigates loss of autonomy.

Indexed as

CommunicationElectronic Health RecordsCommerceHumansautonomyelectronic health record transitionimplementationqualitative researchveteransworkforce

Identifiers

PMID37798579
PMCPMC10593658
OpenAlexW4387362021

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.