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Running head: THE IMPACTS OF ELECTRONIC HEALTH RECORDS 1 The Impacts of Electronic Health Records Name Institution Affiliation Author’s Note
THE IMPACTS OF ELECTRONIC HEALTH RECORDS 2 Table of Contents Chapter 1: Introduction and Objectives ..................................................................................... 5 1.1 Introduction ...................................................................................................................... 5 Chapter 2: Electronic Health Records Explained ....................................................................... 8 2.1 Meaning and Functionalities ............................................................................................ 8 2.2 Dimensions of Electronic Health Records ....................................................................... 8 2.2.1 Information capture ................................................................................................... 8 2.2.2 Information representation ........................................................................................ 9 2.2.3 Operational dimension and data model ..................................................................... 9 2.2.4 Clinical practice ........................................................................................................ 9 2.2.5 Decision support ........................................................................................................ 9 2.2.6 Content ...................................................................................................................... 9 2.2.7 Quality assurance and testing .................................................................................... 9 2.2.8 Interoperability .......................................................................................................... 9 2.2.9 Performance .............................................................................................................. 9 Chapter 3: Benefits and Challenges of Using Electronic Health Records ............................... 10 3.1 Patient-Related Benefits ................................................................................................. 10 3.2 User Related Benefits ..................................................................................................... 10 3.2 Organisational Related Benefits ..................................................................................... 10 3.5 Challenges for Using EHRs ........................................................................................... 11 3.5.1 Correlation between EHRs adoption and adverse patient outcomes ....................... 11 3.5.2 Challenges facing the adoption of EHRs ................................................................ 11 3.5.3 Access to computers ................................................................................................ 12 3.5.4. Lack of expert end-user support ............................................................................. 12 3.5.5 Time as another end-user EHR challenge ............................................................... 12 3.5.6 Loss of data control ................................................................................................. 12 3.5.7. Poor electronic health records risk management ................................................... 13 3.5.8 Clinicians training and after sales experience with vendors ................................... 13 3.5.9 System related errors ............................................................................................... 13 3.6 Possible Approaches to Addressing Barriers to EHRs ................................................... 13 3.6.1 Resources, time, and training .................................................................................. 13 3.6.2 Cost ......................................................................................................................... 14 Chapter 4: Literature Review ................................................................................................... 15 4.1 Introduction .................................................................................................................... 15 4.2 Literature gaps ................................................................................................................ 18 4.3 Explanation on Gaps ...................................................................................................... 18 4.3.1 Quality and safety .................................................................................................... 18 4.3.2 Privacy of records ................................................................................................... 19 4.3.3 Effectiveness of electronic health records ............................................................... 19 Chapter 5: Research Approach ................................................................................................. 20 5.1 Data Collection ............................................................................................................... 20 5.2 Reasons for Choosing a Qualitative Approach to the Study .......................................... 20 5.3 Further Data Collection Tool: Questionnaire ................................................................. 20 5.4 Secondary Data .............................................................................................................. 21 5.5 Research Process ............................................................................................................ 21 5.6 Semi-Structured Interview Questions ............................................................................ 21 5.7 Participants Characteristics and Opinions ...................................................................... 22 5.8 Further Data Collection Emerging During the Interview ............................................... 22 5.9 Sampling Strategy .......................................................................................................... 22 6.0 Evaluation of Positive and Negative Aspects of EHRs .................................................. 22
THE IMPACTS OF ELECTRONIC HEALTH RECORDS 3 6.1 Evaluation of EHRs Performance Based On 8 Variables ............................................... 23 Chapter 6: Results .................................................................................................................... 24 6.1 Questionnaire Analysis ................................................................................................... 24 6.1.0 EHRs Efficiency on quality of care ......................................................................... 24 6.1.2 Perceived Benefits ................................................................................................... 25 6.1.3 EHRs usability ......................................................................................................... 25 6.2 Analysis of Semi-Structured Interviews ........................................................................ 26 6.2.1 Semi-structured interview responses ....................................................................... 26 6.2.2 Positive aspects of EHRs ........................................................................................ 27 6.2.3 Negative Aspects of EHRs ...................................................................................... 27 Chapter 7: Discussions ............................................................................................................. 29 7.1 EHRs Efficiency on Quality Care .................................................................................. 29 7.2 Perceived benefits & challenges .................................................................................... 29 7.3 Usability ......................................................................................................................... 30 Chapter 8: Research Ethics and Considerations ....................................................................... 31 8.1 Research limitations ....................................................................................................... 31 Chapter 9: Summary ................................................................................................................ 32 Chapter 10: Conclusions .......................................................................................................... 33 9.1 Electronic Health Records and Employee Motivation ................................................... 33 9.2 EHRSs versus Clinician Efficiency and Enhancement of Quality Care ........................ 33 Chapter 11: Recommendations and Reflections ...................................................................... 34 References ................................................................................................................................ 35 Appendices ............................................................................................................................... 38 Appendix 1: Participants Characteristics and Opinions ....................................................... 38 Appendix 2: Evaluation of Positive and Negative Aspects of EHRs ................................... 39 Appendix 3: Semi-structured interview questions ............................................................... 40 Appendix 4: Questionnaire .................................................................................................. 41
THE IMPACTS OF ELECTRONIC HEALTH RECORDS 4 The Impacts of Electronic Health Records Chapter 1: Introduction and Objectives 1.1 Introduction

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