Degree of Master of Information Systems and Technology by Research
School of Information Systems and Technology
Zhang, Yiting, The impact of introducing electronic health record systems in residential aged care, Degree of Master of Information Systems and Technology by Research thesis, School of Information Systems and Technology, University of Wollongong, 2012. https://ro.uow.edu.au/theses/3905
Resident health record is an essential information source for the management and delivery of aged care services. Paper-based record is beset by many defences, such as illegibility, missing data, double data entry and difficulty in information retrieving. Electronic health records (EHRs) have been introduced into residential aged care facilities (RACFs) to improve record management. However, to date, the actual impacts of EHRs in RACFs have not been systematically studied. Therefore, the aim of this study was to identify the impacts of EHR systems in RACFs and their causes, and to examine how to overcome the challenges for the implementation of EHR systems.
A qualitative, interpretative research was undertaken. The empirical data was collected from semi-structured interviews of 110 care staff members working in nine RACFs belonging to three organisations. The audio records were transcribed in Microsoft Word. Content analysis was conducted using Microsoft Excel. The updated DeLone and McLean Information Systems Success Model was used as the theoretical framework for data analysis.
The study has identified three categories of impacts, both positive and negative: the impacts on individual care staff members, on residents and on the RACFs. The top 10 frequently mentioned benefits are: quick data retrieval, ease and speed of data input, ease of access, improved format and content of records, enhanced communication with external health care providers, more information about the residents, motivation of staff to enter data, better communication among staff and improved performance appraisal by management. The most obvious negative impact was negative staff attitudes toward documenting resident records in the EHR systems.
The factors leading to these impacts were also examined. The benefits were realised because of the nature of the aged care EHR systems in comparison with paper-based records, the way the systems were used by the staff and the fact that one benefit could lead to another. The negative impacts were caused by the quality of the EHR system, an inadequate approach to the implementation of the system – including lack of training and support – and technical problems with third party products.
Strategies for the introduction of the system that might overcome the challenges of implementation were classified in three categories: hardware allocation, useful additional functions, user interface redesign and training and support.
Although the negative impacts discouraged the care staff members from using the system, the overall benefits led to a smooth organisational transition to electronic documentation practice.