Table 1.

Study sample and electronic medical records system characteristics.

Sample information
Hospital characteristics	400+ bed tertiary care community hospitals in the Midwest US. Both hospitals are nearly identical in the populations they serve, staff training, and type of care provided. Major differences are: Hospital 1's physician staff represents multiple groups whereas Hospital 2's staff is primarily from one physician group; Hospital 2 is faith-based; Hospital 1 is a single, locally governed hospital whereas Hospital 2 is a multi-hospital system governed from outside the region.
Physician participants' specialties (number of participants)	General medicine (10), Anesthesiology (2), Obstetrics/Gynecology (2), Psychiatry (2), Cardiology (1), Orthopedics (1), Ophthalmology (1), Rheumatology (1)
Males / Females	15 / 5
Age
30 – 39	6
40 – 49	7
50 – 59	6
60+	1
Average years in job (range)	15 (4 – 32)
Average years computer experience (range)	20 (10 – 30)
Comfort with general technology (range)a	7.6 (3 – 10)
Comfort with hospital technology (range) a	7.7 (5 – 10)
Electronic medical records (EMR) systems at the time of the interviews
Hospital's stated aim of the system	Hospital 1: Initially to manage business (e.g., billing) with new electronic system and, at the time of the interviews, starting to focus more on improving patient care. Hospital 2: Improved quality of care, improved satisfaction, and improved efficiency.
Type of system	A commercial EMR system. The same, top-ranked national vendor of EMRs provided the system for both hospitalsb The vendor provided the software structure but the hospitals had to fill in much of the content, e.g., developing hospital-specific workflows and templates. Software modifications were made by the vendor, in response to hospital requests.
Type of clinical information managed by the system	Hospital 1: All nursing documentation except nursing notes and care plan; all transcribed medication and non-medication orders except nursing orders; laboratory results; medical imaging results and links to images; dictation transcriptions; reports from ancillary services/third parties; unofficial hand-off reports for some physicians. Hospital 2: All documentation by all providers (except in anesthesiology department); all orders; laboratory results; links to medical images and EKGs; dictation transcriptions; medical records tracking (e.g., deficiencies).
Clinical tasks supported by the system	Hospital 1: Nursing documentation, order transcription, and physician review of clinical data. Hospital 2: All documentation and order entry.
Extent and users of the system	Hospital 1: 4,450 total users, including 552 physician users (excluding residents); 550 residents, interns, and medical students; and 1,052 nurses from all nursing units. Hospital 2: 3,376 total users; 283 physicians, 1,100 nurses
Functionality (for physicians)	Hospital 1: Data repository/retrieval only.c Hospital 2: Data repository/retrieval, computerized clinical documentation, computerized order entry. Both hospitals also had computerized patient admission, transfers, and discharges; patient scheduling; billing; and pharmacy order and dispensing.
Approximate duration of system use at the time of interview	Hospital 1: 3 years. Hospital 2: 9 months (data repository and documentation); 7 months (order entry).

^aOn a 10-point scale (1 = extremely uncomfortable, 10 = extremely comfortable)

^bIn addition, the same vendor provided outpatient EMR systems for physicians' clinics and ten physicians provided information on their outpatient EMR experiences as well

^cTwo physicians at Hospital 1 were in the pilot unit for an order entry module and provided data on the first few weeks of using EMR with order entry functionality