Nurses' views on the use, quality and user satisfaction with electronic medical records: questionnaire development.

AIM: This paper is a report of the development of an instrument to measure nurses' views on the use, quality and user satisfaction with electronic medical records systems. BACKGROUND: Use of electronic medical records systems in hospitals is steadily increasing, yet no validated instruments have assessed the effectiveness of these systems from the viewpoint of nurses. METHOD: Items were designed following a literature review based on three main constructs: use, quality and user satisfaction with electronic medical records. Reliability and validity were examined based on responses from 1,666 nurses from 42 hospitals in Japan in February 2006. Exploratory factor analysis was conducted to determine the degree to which each item within a construct was associated. The reliability of each resultant factor was computed using Cronbach's alpha coefficient. Content validity was addressed by basing the items on previous surveys and review of the instrument by a panel of nurses experienced in nursing informatics. Construct validity was examined through factor analysis and correlational analyses. FINDINGS: Extent of 'use' of electronic medical records resulted into three factors with good factor loadings, but only two had acceptable reliability. 'Quality' of electronic medical records had two factors with good factor loadings and reliability. 'User satisfaction' with electronic medical records had three factors, but only one had acceptable reliability. 'Use' and 'quality' constructs were positively correlated with 'user satisfaction'. CONCLUSION: The final instrument incorporates 34 items from the original 44-item pool. Initial validity results were positive and therefore the instrument can be used in evaluating electronic medical records in hospitals.

Evaluation of electronic health records from viewpoint of patients.

OBJECTIVE: To clarify the impacts of electronic health records (EHRs) on patients, especially patient's satisfaction by using questionnaire. DESIGN: Surveys were conducted at three hospitals. One of them was surveyed three times; three-months before (pre-EHR) and three-months after (post-3mo EHR) and nine-months after implementation of EHR (post-9mo EHR). The other two hospitals (metropolitan-stable EHR and suburban-stable EHR) spent more than three years after implementation. Thus there were five stages of EHR. MEASUREMENTS: Comparisons were made among these five stages. RESULTS: The longer EHR has been operating, the more patients answered waiting time shortened. The patients in pre-EHR (73%) expected the benefit of cooperation between hospitals and clinics using EHR more. The longer experience of EHR a hospital had, the more patients were explained by watching the screen. Although overall satisfaction was high, there was no difference among the stages except metropolitan-stable EHR. CONCLUSION: Main benefits of EHR are reducing patient's waiting time, and enhancing explanation to patients. However it does not have significant effects to improve patient's satisfaction.