ArticleJournal of general internal medicine2023
Assessing Electronic Health Record (EHR) Use during a Major EHR Transition: An Innovative Mixed Methods Approach.
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 7 papers.
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Who cites it
7 citing papers in PubMed.
- Article
- Comparing Work Experiences of Internal Medicine Physicians in Veterans Affairs and Non-Federal Hospitals: A National Survey.Journal of general internal medicine · 2026Article
- Data in Diabetic Foot Care: From Current State to a Management Framework for Implementation.Journal of clinical medicine · 2025Review
- Does autotext usage decrease documentation time among resident physicians? A retrospective analysis of electronic health record usage data.JAMIA open · 2025Article
- Usability Challenges in Electronic Health Records: Impact on Documentation Burden and Clinical Workflow: A Scoping Review.Journal of evaluation in clinical practice · 2025Article
- VA's EHR transition and health professions trainee programs: Findings and impacts of a multistakeholder learning community.Learning health systems · 2025Article
- User Experiences of Transitioning From a Homegrown Electronic Health Record to a Vendor-Based Product in the Department of Veterans Affairs: Qualitative Findings From a Mixed Methods Evaluation.JMIR formative research · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundElectronic health record (EHR) transitions are inherently disruptive to healthcare workers who must rapidly learn a new EHR and adapt to altered clinical workflows. Healthcare workers' perceptions of EHR usability and their EHR use patterns following transitions are poorly understood. The Department of Veterans Affairs (VA) is currently replacing its homegrown EHR with a commercial Cerner EHR, presenting a unique opportunity to examine EHR use trends and usability perceptions.
objectiveTo assess EHR usability and uptake up to 1-year post-transition at the first VA EHR transition site using a novel longitudinal, mixed methods approach.
designA concurrent mixed methods strategy using EHR use metrics and qualitative interview data.
participants141 clinicians with data from select EHR use metrics in Cerner Lights On Network®. Interviews with 25 healthcare workers in various clinical and administrative roles. APPROACH: We assessed changes in total EHR time, documentation time, and order time per patient post-transition. Interview transcripts (n = 90) were coded and analyzed for content specific to EHR usability. KEY
resultsTotal EHR time, documentation time, and order time all decreased precipitously within the first four months after go-live and demonstrated gradual improvements over 12 months. Interview participants expressed ongoing concerns with the EHR's usability and functionality up to a year after go-live such as tasks taking longer than the old system and inefficiencies related to inadequate training and inherent features of the new system. These sentiments did not seem to reflect the observed improvements in EHR use metrics.
conclusionsThe integration of quantitative and qualitative data yielded a complex picture of EHR usability. Participants described persistent challenges with EHR usability 1 year after go-live contrasting with observed improvements in EHR use metrics. Combining findings across methods can provide a clearer, contextualized understanding of EHR adoption and use patterns during EHR transitions.
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