title: Transitioning between ambulatory EHRs: a study of practitioners' perspectives.
abstract: OBJECTIVE
  To evaluate practitioners' expectations of, and satisfaction with, older and newer electronic health records (EHRs) after a transition.
  
  
  METHODS
  Pre- and post-transition survey administered at six academic-affiliated ambulatory care practices from 2006 to 2008. Four practices transitioned to one commercial EHR and two practices to another. We compared respondents' expectations of, and satisfaction with, the newer EHR.
  
  
  RESULTS
  523 subjects were eligible: 217 were available before transition and 306 after transition. 162 pre-transition and 197 post-transition responses were received, yielding 75% and 64% response rates, respectively. Practitioners were more satisfied with the newer EHRs (64%) compared with the older (56%) (p=0.15) and a small majority (58%) were satisfied with the transition. Practitioners' satisfaction with the older EHRs for completing clinical tasks was high. The newer EHRs exceeded practitioner expectations regarding remote access (61% vs 74%; p=0.03). However, the newer EHRs did not meet practitioners' expectations regarding their ability to perform clinical tasks, or more globally, improve medication safety (81% vs 61%; p<0.001), efficiency (70% vs 44%; p<0.001), and quality of care (77% vs 67%; p=0.04).
  
  
  CONCLUSIONS
  Most practitioners had favorable opinions about EHRs and reported overall improved satisfaction with the newer EHRs. However, practitioners' high expectations of the newer EHRs were often unmet regarding facilitation of specific clinical tasks or for improving quality, safety, and efficiency.
  
  
  CONCLUSIONS
  To ensure practitioners' expectations, for instance regarding improvements in medication safety, are met, vendors should develop and implement refinements in their software as practices upgrade to newer, certified EHRs.
authors.affiliation: Department of Pediatrics, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Stephanie O
authors.initials: SO
authors.lastname: Zandieh
authors.forename: Erika L
authors.initials: EL
authors.lastname: Abramson
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Pfoh
authors.forename: Kay
authors.initials: K
authors.lastname: Yoon-Flannery
authors.forename: Alison
authors.initials: A
authors.lastname: Edwards
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D000328:Adult; D000555:Ambulatory Care Information Systems; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D057286:Electronic Health Records; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009519:New York City; D009936:Organizational Innovation; D057188:Workflow