title: Impact of EPR systems on information flow in Finnish health centers.
abstract: BACKGROUND
  We studied how well healthcare personnel in healthcare centers (HCs) in the South Ostrobothnia region of Finland are able to obtain patient information thorough electronic patient record (EPR) systems. This study followed the changes in availability of patient information during a 7-year period, from 2003 to the end of 2010. The patient group studied focused on those involved in anticoagulant (AC) treatment.
  
  
  METHODS
  A structured questionnaire was sent in 2003 to the staff of 15 HCs. The questionnaire dealt with access and availability of patient information from the EPR. Respondents were asked to rate how often they obtain information concerning AC treatment from various sources.
  
  
  RESULTS
  In total, 1,114 questionnaires were sent, and 860 answers were received; the response rate was 77%. A repeat study was conducted in 2010, and 932 responses were obtained (response rate, 56%). Paper-based AC treatment cards carried by the patients were an important information source for 75.0% of the respondents in 2003 and 55.4% in 2010. For all new AC treatments, the EPR was a primary information source for 33.3% of respondents in 2003 and 60.2% in 2010.
  
  
  CONCLUSIONS
  This study indicated that during the study period there was an improvement in access to EPR but that this did not always improve the overall availability of data. Results show that problems in information flow from secondary care to the HCs persist. Almost half of the patients dealt with in the HCs were affected by at least some problems. In the 7 years covered by this study, EPR systems have become more important as information sources for clinical data, but there is still room for improvement.
authors.affiliation: Department of Biomedical Engineering, Tampere University of Technology, Seinäjoki, Finland. kari.makela@tut.fi
authors.forename: Kari
authors.initials: K
authors.lastname: Mäkelä
authors.forename: Irma
authors.initials: I
authors.lastname: Virjo
authors.forename: Juhani
authors.initials: J
authors.lastname: Aho
authors.forename: Pentti
authors.initials: P
authors.lastname: Kalliola
authors.forename: Harri
authors.initials: H
authors.lastname: Kurunmäki
authors.forename: Leena
authors.initials: L
authors.lastname: Uusitalo
authors.forename: Markku
authors.initials: M
authors.lastname: Valli
authors.forename: Suvi
authors.initials: S
authors.lastname: Ylinen
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D003142:Communication; D003376:Counseling; D004305:Dose-Response Relationship, Drug; D057286:Electronic Health Records / Q000458:organization & administration* / Q000706:statistics & numerical data; D005387:Finland; D006282:Health Personnel; D006801:Humans; D019934:International Normalized Ratio
chemical_list: D000925:Anticoagulants