Attitudes About Electronic Medical Record Keeping
Darren D. Cooke, BS
University of California
See http://biomech2.me.berkeley.edu/computer_use.html for on-line poster
INTRODUCTION: The purpose of this study was to assess the influence of University of California, San Francisco (UCSF) physicians' experience with computers, on attitudes about electronic medical record-keeping (EMR) and computer usage in a clinical environment. It was hypothesized that individuals with greater computer experience would have a more favorable opinion of EMR.
METHODS: A survey was devised that assessed the frequency and nature of computer use, and opinions regarding EMR. 523 surveys were mailed to UCSF faculty physicians, of which 185 (35%) were returned. A computer usage score and EMR attitude score were calculated for each response based on simple algorithms. Computer usage was based on: frequency of computer use at home and at work, and number of applications, operating systems, and services the respondent used or was familiar with. EMR attitude was based on: beliefs regarding the effects of EMR on areas such as efficiency, accuracy, record security, and the doctor-patient relationship.
RESULTS: Respondents with a high computer usage score had a more positive EMR attitude score than those with low computer usage (4.4 v 2.2; range -10 to 10; P<0.001). High computer usage respondents, when compared to low usage, were more likely (P<0.02) to agree with statements such as EMR will "decrease record-keeping time" (0.6 v 0.3 where -1=disagree, 0=no effect, 1=agree), "improve accuracy of records" (0.8 v 0.6), and "allow more time to interact with patients" (0.3 v -0.1). High computer usage respondents were more likely (P<0.05) to disagree with statements such as EMR will "compromise patient record security" (-0.1 v 0.2), and "negatively affect the doctor-patient relationship" (-0.4 v -0.2). High usage respondents agreed to an average of 7.0 (of 9 offered) potential advantages of EMR, compared to 5.4 agreements by low usage respondents (P<0.001). No significant differences were found among high and low computer usage respondents with regard to amount of patient contact per week, most frequent data recording method (e.g. dictation, hand-write, etc.), the number of agreements regarding potential disadvantages of EMR, or the statement that EMR will "intimidate most patients". High usage respondents averaged 17.6 years since medical school graduation; low usage respondents averaged 23.5 years (P<0.001).
DISCUSSION: Data suggest that increasing physicians' knowledge and usage of computers may improve acceptance of EMR. Data also suggest that younger physicians have a more favorable opinion of EMR; the trend will likely be toward greater acceptance of EMR. The correlation found may be influenced by other factors, however. For example, the return sample may be self-selecting, or physicians with an interest in EMR may tend to have more interest and thus more experience with computers.