title: The Growing Gap in Electronic Medical Record Satisfaction Between Clinicians and Information Technology Professionals: Issues of Most Concern and Suggested Remediations.
abstract: BACKGROUND
  With the alarming statistics concerning the quality of national health care, it is hoped that electronic health records (EHRs) will reduce inefficiencies associated with medical delivery and improve patient safety. This study reports the results of a survey that demonstrates a pattern in EHR system implementation that indicates that health-care information technology decisions are based more on the preferences of information technology professionals (ITPs) and hospital administrators than clinicians.
  
  
  METHODS
  We present survey data highlighting the growing discrepancy in EHR-related satisfaction between clinicians and ITPs. We conducted a literature search to identify major barriers that must be overcome to achieve optimal EHR benefits. We summarize our recommendations in order to maximize the favorable impact of EHRs on the health-care system.
  
  
  RESULTS
  The existing gap in postimplementation EHR satisfaction ratings between ITPs and clinicians reveals an underlying systematic problem. Electronic medical record vendors perceive administrators and ITPs as the "buyers" for many EHR systems, and their needs are given higher priority than those of clinicians. This possibly may lead to the lack of clinically optimized EHRs, with systems often presenting as rigid and standardized with a limited exchange of health information.
  
  
  CONCLUSIONS
  EHRs have the potential to become a powerful tool that may improve many processes related to health care, including quality, safety, and economical aspects. The involvement of physicians in every step of the process, from electronic medical record selection to acquisition, implementation, and ongoing optimization, is crucial for enabling the achievement of the medical organization's mission.
authors.affiliation: Department of Orthopaedic Surgery, 1 Jarrett White Road, Tripler Army Medical Center, Honolulu, HI 96859.
authors.forename: James S
authors.initials: JS
authors.lastname: Shaha
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679. E-mail address for K.J. Saleh: ksaleh@siumed.edu.
authors.forename: Mouhanad M
authors.initials: MM
authors.lastname: El-Othmani
authors.affiliation: Department of Orthopaedic Surgery, University of California, 1500 Owens Street, San Francisco, San Francisco, CA 94158.
authors.forename: Jamal K
authors.initials: JK
authors.lastname: Saleh
authors.affiliation: Department of Orthopaedic Surgery, University of California, 1500 Owens Street, San Francisco, San Francisco, CA 94158.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bozic
authors.affiliation: The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Wright
authors.affiliation: Steadman Hawkins Clinic of the Carolinas, 200 Patewood Drive, Suite C100, Greenville, SC 29615.
authors.forename: John M
authors.initials: JM
authors.lastname: Tokish
authors.affiliation: Center for Public Policy and Administration, 260 South Central Campus Drive, Room 214, University of Utah, Salt Lake City, UT 84112.
authors.forename: Steve H
authors.initials: SH
authors.lastname: Shaha
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679. E-mail address for K.J. Saleh: ksaleh@siumed.edu.
authors.forename: Khaled J
authors.initials: KJ
authors.lastname: Saleh
mesh_terms: D001291:Attitude of Health Personnel; D057286:Electronic Health Records / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D008490:Medical Informatics / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States