Karen A. Wager

Impact of an Electronic Medical Record System on Community-Based Primary Care Practices

Background: Although primary care physicians are increasingly interested in adopting electronic medical record (EMR) systems, few use such systems in practice. This study explores the organizational impact of an EMR system on community-based practices that have overcome the initial barriers and are experienced EMR users. Methods: Five primary care practices that are members of a national research network participated in this study. Using qualitative methods, including semistructured interviews and observations, we assessed the impact of an EMR system on the work lives of various user groups. Results: Physicians and staff indicated that the EMR system has changed not only how they manage patient records but also how they communicate with each other, provide patient care services, and perform job responsibilities. The EMR is also perceived by its users to have an impact on practice costs. Although in most practices physicians and staff were unaware of actual expenses and cost savings associated with the EMR, those in practices that have eliminated duplicate paper-based systems believe they have realized cost savings. Conclusions: Several important themes emerged. The organizational context in which the system is implemented is important. Effective leadership, the presence of a system champion, availability of technical training and support, and adequate resources are essential elements to the success of the EMR.

The Presidential Scholars Program at the Medical University of South Carolina: An extracurricular approach to interprofessional education

The Medical University of South Carolina (MUSC) developed a Presidential Scholars Program (PSP) in order to foster interprofessional collaboration among students from the different health professions on campus. Now in its seventh year, the program provides approximately 40 selected students each year from six different colleges with a two-semester interprofessional educational experience. Students work in small interprofessional teams on a project designed to address a broad-based health care issue; they also participate in other structured educational sessions throughout the year. As one means for assessing student impressions of the interprofessional collaborative experience, a survey was administered prior to and immediately after the experience. Additionally, a sample of non-scholar MUSC students was randomly selected for completion of the survey as a control group. Results indicate that PSP students have a significantly greater understanding of each other and deeper appreciation of the value of interprofessional collaboration at the end of the year. The Presidential Scholars Program at MUSC provides a unique and innovative opportunity for students to work with individuals within other health care disciplines, reduces stereotypes of the various professions and teaches important team skills. Future research would involve alumni follow-up in order to further evaluate the long-term impact of the program.

Assessing Physician and Nurse Satisfaction with an Ambulatory Care EMR: One Facility's Approach

Evaluating clinician satisfaction with an electronic medical record (EMR) system is an important dimension to overall acceptance and use, yet project managers often lack the time and resources to formally assess user satisfaction and solicit feedback. This article describes the methods used to assess clinician satisfaction with an EMR and identify opportunities for improving its use at a 300-physician academic practice setting. We administered an online survey to physicians and nurses; 244 (44%) responded. We compared physician and nurse mean ratings across 5 domains, and found physicians’ satisfactions scores were statistically lower than nurses in several areas (p