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Features and frequency of use of electronic health records in primary care across 20 countries : a cross-sectional study

Kerr, G. ; Kulshreshtha, N. ; Greenfield, G. ; Li, E. ; Beaney, T. ; Hayhoe, B. W.J. ; Car, J. ; Clavería, A. ; Collins, C. and Espitia, S. M. , et al. (2024) In Public Health 233. p.45-53
Abstract

Objectives: Variation exists in the capabilities of electronic healthcare records (EHRs) systems and the frequency of their use by primary care physicians (PCPs) from different settings. We aimed to examine the factors associated with everyday EHRs use by PCPs, characterise the EHRs features available to PCPs, and to identify the impact of practice settings on feature availability. Study design: Cross-sectional study. Methods: PCPs from 20 countries completed cross-sectional online survey between June and September 2020. Responses which reported frequency of EHRs use were retained. Associations between everyday EHRs use and PCP and practice factors (country, urbanicity, and digital maturity) were explored using multivariable logistic... (More)

Objectives: Variation exists in the capabilities of electronic healthcare records (EHRs) systems and the frequency of their use by primary care physicians (PCPs) from different settings. We aimed to examine the factors associated with everyday EHRs use by PCPs, characterise the EHRs features available to PCPs, and to identify the impact of practice settings on feature availability. Study design: Cross-sectional study. Methods: PCPs from 20 countries completed cross-sectional online survey between June and September 2020. Responses which reported frequency of EHRs use were retained. Associations between everyday EHRs use and PCP and practice factors (country, urbanicity, and digital maturity) were explored using multivariable logistic regression analyses. The effect of practice factors on the variation in availability of ten EHRs features was estimated using Cramer's V. Results: Responses from 1520 out of 1605 PCPs surveyed (94·7%) were retained. Everyday EHRs use was reported by 91·2% of PCPs. Everyday EHRs use was associated with PCPs working >28 h per week, having more years of experience using EHRs, country of employment, and higher digital maturity. EHRs features concerning entering, and retrieving data were available to most PCPs. Few PCPs reported having access to tools for ‘interactive patient education’ (37·3%) or ‘home monitoring and self-testing of chronic conditions’ (34·3%). Country of practice was associated with availability of all EHRs features (Cramer's V range: 0·2–0·6), particularly with availability of tools enabling patient EHRs access (Cramer's V: 0·6, P < 0.0001). Greater feature availability of EHRs features was observed with greater digital maturity. Conclusions: EHRs features intended for patient use were uncommon across countries and levels of digital maturity. Systems-level research is necessary to identify the country-specific barriers impeding the implementation of EHRs features in primary care, particularly of EHRs features enabling patient interaction with EHRs, to develop strategies to improve systems-wide EHRs use.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Digital Health, EHRs, Electornic health records, Primary Care, Quality of care, Telemedicine, Virtual Care
in
Public Health
volume
233
pages
9 pages
publisher
Elsevier
external identifiers
  • pmid:38848619
  • scopus:85195019480
ISSN
0033-3506
DOI
10.1016/j.puhe.2024.05.001
language
English
LU publication?
yes
id
cc9ed6da-7da3-4a3b-8f2d-f50aa86e2905
date added to LUP
2024-08-12 14:53:28
date last changed
2024-08-12 14:54:44
@article{cc9ed6da-7da3-4a3b-8f2d-f50aa86e2905,
  abstract     = {{<p>Objectives: Variation exists in the capabilities of electronic healthcare records (EHRs) systems and the frequency of their use by primary care physicians (PCPs) from different settings. We aimed to examine the factors associated with everyday EHRs use by PCPs, characterise the EHRs features available to PCPs, and to identify the impact of practice settings on feature availability. Study design: Cross-sectional study. Methods: PCPs from 20 countries completed cross-sectional online survey between June and September 2020. Responses which reported frequency of EHRs use were retained. Associations between everyday EHRs use and PCP and practice factors (country, urbanicity, and digital maturity) were explored using multivariable logistic regression analyses. The effect of practice factors on the variation in availability of ten EHRs features was estimated using Cramer's V. Results: Responses from 1520 out of 1605 PCPs surveyed (94·7%) were retained. Everyday EHRs use was reported by 91·2% of PCPs. Everyday EHRs use was associated with PCPs working &gt;28 h per week, having more years of experience using EHRs, country of employment, and higher digital maturity. EHRs features concerning entering, and retrieving data were available to most PCPs. Few PCPs reported having access to tools for ‘interactive patient education’ (37·3%) or ‘home monitoring and self-testing of chronic conditions’ (34·3%). Country of practice was associated with availability of all EHRs features (Cramer's V range: 0·2–0·6), particularly with availability of tools enabling patient EHRs access (Cramer's V: 0·6, P &lt; 0.0001). Greater feature availability of EHRs features was observed with greater digital maturity. Conclusions: EHRs features intended for patient use were uncommon across countries and levels of digital maturity. Systems-level research is necessary to identify the country-specific barriers impeding the implementation of EHRs features in primary care, particularly of EHRs features enabling patient interaction with EHRs, to develop strategies to improve systems-wide EHRs use.</p>}},
  author       = {{Kerr, G. and Kulshreshtha, N. and Greenfield, G. and Li, E. and Beaney, T. and Hayhoe, B. W.J. and Car, J. and Clavería, A. and Collins, C. and Espitia, S. M. and Fernandez, M. J. and Gusso, G. and Hoedebecke, K. and Hoffman, R. D. and Irving, G. and Jimenez, G. and Laranjo, L. and Lazić, V. and Lingner, H. and Memarian, E. and Nessler, K. and O'Neill, B. G. and Petek, D. and Serafini, A. and Ungan, M. and Majeed, A. and Neves, A. L.}},
  issn         = {{0033-3506}},
  keywords     = {{Digital Health; EHRs; Electornic health records; Primary Care; Quality of care; Telemedicine; Virtual Care}},
  language     = {{eng}},
  pages        = {{45--53}},
  publisher    = {{Elsevier}},
  series       = {{Public Health}},
  title        = {{Features and frequency of use of electronic health records in primary care across 20 countries : a cross-sectional study}},
  url          = {{http://dx.doi.org/10.1016/j.puhe.2024.05.001}},
  doi          = {{10.1016/j.puhe.2024.05.001}},
  volume       = {{233}},
  year         = {{2024}},
}