The role of allied health leadership in the implementation of an electronic medical record

Ms Jane Carlin1, Mr Adam  Stormont1, Ms Naomi Dobroff1, Dr Suong Le1

1Monash Health, Clayton, Australia

Aim

Electronic Medical Records (EMRs) represent a core strategy for future healthcare delivery. This multidisciplinary study evaluated baseline clinician perception, knowledge and expectation of an EMR on clinical workflow, patient care and research productivity.

Method

A mixed method two phase study was conducted at Monash Health, VIC from March to August 2016.  This consisted of an 18 item, literature derived questionnaire evaluating demographics, satisfaction, clinical workflow, clinical efficiency and qualitative feedback.  This was followed by a time motion study measuring direct clinical time and barriers to clinical workflow.

Results

809 clinicians participated in the survey (89 physiotherapy, 61 pharmacy, 213 medical, 456 nursing and midwifery) across 4 Monash Health hospitals. 64.7% of respondents reported low satisfaction with current workflow on a 5 point Likert Scale.

Domains reported as likely to benefit from an EMR included: improved patient quality of care, reduced medication error and increased research efficiency. Respondents aged over 50 were more sceptical regarding the potential benefits of an EMR (p-value <0.001). The time motion study verified the clinical workflow barriers identified in the survey.

Core challenges identified were: hardware access; handwritten documentation ambivalence; impact on patient rapport; lack of visible leadership; user experience; and staff communication.

Significance of the findings to Allied Health:

This is the first study to characterise the baseline perception, knowledge and expectation of a multidisciplinary workforce towards an EMR. The EMR is a catalyst for clinical workflow reform but Allied Health leadership is essential if we are to realise its true potential to improve patient safety, quality of care and clinical research output.