Cited by 146Electronic Health Records SystemsNursing Diagnosis and DocumentationInformation Systems Theories and Implementation

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Exploring the persistence of paper with the electronic health record

Saleem, Jason J., Russ, Alissa L., Justice, Connie F., Hagg, Heather, Ebright, Patricia R., Woodbridge, Peter A., Doebbeling, Bradley N.·2009·International Journal of Medical Informatics

DOI 10.1016/j.ijmedinf.2009.04.001

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Abstract

Objective Healthcare organizations are increasingly implementing electronic health records (EHRs) and other related health information technology (IT). Even in institutions which have long adopted these computerized systems, employees continue to rely on paper to complete their work. The objective of this study was to explore and understand human-technology integration factors that may be causing employees to rely on paper alternatives to the EHR.Methods We conducted semi-structured interviews with 20 key-informants in a large Veterans Affairs Medical Center (VAMC), with a fully implemented EHR, to understand the use of paper-based alternatives. Participants included clinicians, administrators, and IT specialists across several service areas in the medical center.Results We found 11 distinct categories of paper-based workarounds to the use of the EHR. Paper use related to the following: (1) efficiency; (2) knowledge/skill/ease of use; (3) memory; (4) sensorimotor preferences; (5) awareness; (6) task specificity; (7) task complexity; (8) data organization; (9) longitudinal data processes; (10) trust; and (11) security. We define each of these and provide examples that demonstrate how these categories promoted paper use in spite of a fully implemented EHR.Conclusions In several cases, paper served as an important tool and assisted healthcare employees in their work. In other cases, paper use circumvented the intended EHR design, introduced potential gaps in documentation, and generated possible paths to medical error. We discuss implications of these findings for EHR design and implementation.

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Authors: Saleem, J. J., Russ, A. L., Justice, C. F., Hagg, H., Ebright, P. R., Woodbridge, P. A., & Doebbeling, B. N.
Affiliations: Regenstrief Institute (US)
Indiana University Indianapolis (US)
VA Nebraska Western Iowa Health Care System (US)
Corresponding author: Saleem, Jason J.
ORCID: Saleem, Jason J.
Russ, Alissa L.
Doebbeling, Bradley N.
Venue: International Journal of Medical Informatics
Publisher: Elsevier BV
Published: 2009-09
Volume: 78
Issue: 9
Pages: 618-628
ISSN: 1386-5056 (ISSN-L)
DOI: 10.1016/j.ijmedinf.2009.04.001
OpenAlex: W1965739756
Semantic Scholar: 6f73746d8f0c94b5309f7465ff317ebb22d05f29
Cited by: 145
References: 28
Citations by year: 2026: 3 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 8 · 2021: 6 · 2020: 6 · 2019: 7 · 2018: 10 · 2017: 6 · 2016: 12 · 2015: 11 · 2014: 12 · 2013: 15 · 2012: 9
FWCI: 29.55
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: International Journal of Medical Informatics (publishedVersion)
PubMed (publishedVersion)
Funders: Health Services Research and Development
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Nursing › Research and Theory › Nursing Diagnosis and Documentation
Social Sciences › Business, Management and Accounting › Management Information Systems › Information Systems Theories and Implementation
Keywords: electronic health records, human-technology integration, health information technology adoption, EHR design, clinical documentation, medical errors, veterans' health care, clinician behavior, task complexity, data security
MeSH terms: Documentation, Indiana, Medical History Taking, Paper, Practice Patterns, Physicians', Medical Records Systems, Computerized

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