title: Why aren't they happy? An analysis of end-user satisfaction with Electronic health records.
abstract: Introduction. Implementations of electronic health records (EHR) have been met with mixed outcome reviews. Complaints about these systems have led to many attempts to have useful measures of end-user satisfaction. However, most user satisfaction assessments do not focus on high-level reasoning, despite the complaints of many physicians. Our study attempts to identify some of these determinants.Method. We developed a user satisfaction survey instrument, based on pre-identified and important clinical and non-clinical clinician tasks. We surveyed a sample of in-patient physicians and focused on using exploratory factor analyses to identify underlying high-level cognitive tasks. We used the results to create unique, orthogonal variables representative of latent structure predictive of user satisfaction.Results.Our findings identified 3 latent high-level tasks that were associated with end-user satisfaction: a) High- level clinical reasoning b) Communicate/coordinate care and c) Follow the rules/compliance.Conclusion: We were able to successfully identify latent variables associated with satisfaction. Identification of communicability and high-level clinical reasoning as important factors determining user satisfaction can lead to development and design of more usable electronic health records with higher user satisfaction.
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Prasad
authors.initials: P
authors.lastname: Unni
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Catherine
authors.initials: C
authors.lastname: Staes
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Howard
authors.initials: H
authors.lastname: Weeks
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Heidi
authors.initials: H
authors.lastname: Kramer
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Damion
authors.initials: D
authors.lastname: Borbolla
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Stacey
authors.initials: S
authors.lastname: Slager
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Teresa
authors.initials: T
authors.lastname: Taft
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah.
authors.forename: Valliammai
authors.initials: V
authors.lastname: Chidambaram
authors.affiliation: University of Utah, School of Medicine, Salt Lake City, Utah; SLC VA IDEAS Center of Innovation, Salt Lake City, Utah.
authors.forename: Charlene
authors.initials: C
authors.lastname: Weir
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003071:Cognition; D003661:Decision Support Techniques; D057286:Electronic Health Records; D005163:Factor Analysis, Statistical; D006801:Humans; D007588:Job Satisfaction; D008505:Medical Staff, Hospital; D011795:Surveys and Questionnaires