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First published August 23, 2006 as JAMIA PrePrint; doi:10.1197/jamia.M2108
Journal of the American Medical Informatics Association 2006;13(6):668-675
© 2006 American Medical Informatics Association

A more recent version of this article appeared on November 1, 2006
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Submitted on March 21, 2006
Accepted on July 17, 2006

From the front line, report from a near paperless hospital: Mixed reception amongst health care professionals

Jan-Tore Lium MSc1*, Hallvard Laerum MD, PhD2, Tom Schulz MD, PhD3, and Arild Faxvaag MD, PhD4

Affiliation of the authors: 1 Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology (NTNU), Trondheim, Norway ; 2 Rikshospitalet University Hospital, Oslo, Norway ; 3 Sorlandet Hospital HF, Arendal, Norway ; 4 Norwegian Research Centre for Electronic Patient Records, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

* To whom correspondence should be addressed.

Objective Many Norwegian hospitals that are equipped with an electronic medical record (EMR) system now have proceeded to withdraw the paper-based medical record from clinical workflow. In two previous survey-based studies on the effect of removing the paper-based medical record on the work of physicians, nurses and medical secretaries, we concluded that to scan and eliminate the paper based record was feasible, but that the medical secretaries were the group that reported to benefit the most from the change. To further explore the effects of removing the paper based record, especially in regard to medical personnel, we now have conducted a follow up study of a hospital that has scanned and eliminated its paper-based record.

Design A survey of 27 physicians, 60 nurses and 30 medical secretaries. The results were compared with those from a previous study conducted three years earlier at the same department.

Measurements The questionnaire (see online appendix) covered the frequency of use of the EMR system for specific tasks by physicians, nurses and medical secretaries, the ease of performing these tasks compared to previous routines, user satisfaction and computer literacy.

Results Both physicians and nurses displayed increased use of the EMR compared to the previous study, while medical secretaries reported generally unchanged but high use.

Conclusion The increase in use was not accompanied by a similar change in factors such as computer literacy or technical changes, suggesting that these typical success factors are necessary but not sufficient.






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