​Installing an electronic health record (EHR) may cause greater physician satisfaction and increased patient dissatisfaction, according to a study in the August 2018 issue of Journal of the American Medical Informatics Association. Using surveys to examine the effects of EHR installation on both provider satisfaction with information flow and patient satisfaction with their quality of care at obstetrician-gynecology (OB-GYN) offices, researchers found mixed results. Obstetrician-gynecologists (ob-gyns) reported being more satisfied with their access to patient records from the inpatient perinatal triage unit once the EHR was programmed to automatically populate the inpatient data in the ob-gyn office EHR. However, when it came to how the EHR affected work processes, ob-gyns reported being more dissatisfied than other clinical or non-clinical staff, according to the study. After the EHR was installed, researchers found that patient satisfaction dropped. According to the study, they did not find evidence that patient satisfaction increased as the EHR became more integrated. As the study's authors conclude, it may be that patient satisfaction is negatively impacted by provider dissatisfaction and the trouble that providers may have while integrating EHR technology into patient care. Physician offices should be careful to keep the lines of communication with patients open during EHR installation while continuing to meet documentation requirements.

HRC Recommends: Appropriate use of EHRs requires significant planning and workflow assessment, including involvement of frontline users in preparation; thorough training and support during and after implementation; periodic review of EHR use and feedback; and ongoing monitoring and improvement. Healthcare organizations should involve physicians and staff in evaluating and implementing EHRs, as well as ongoing monitoring and improvement. Risk managers may wish to engage their facility's information technology (IT) department to survey physician satisfaction with their EHR systems to determine the problems physicians experience and improvements that may be feasible.