| Supporting hardware and software |
“One of the biggest facilitation [is] the remote access, um, because as much as you like to do things real-time, the world doesn't let you do everything real-time because of competing goals and needs and such. So the ability to access it from home, access it from the hospital, use downtime more efficiently, um, whereas before, if you, you had downtime at a time where your, the charts were, you know, 10 miles away, you weren't going to be able to do anything.” (Family medicine physician, H2) “At the hospital, there are computers everywhere, so access is, is very easy. And so I think access to the, to a computer was an important part of what made it easier. There are, um, a number of them scattered through the central nursing station. There is a computer on wheels in every room, used more often by the nursing staff for bedside, but I would log on to that occasionally.” (General medicine hospitalist, H2)
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| Speed |
“I don't have trouble finding a computer. I have to find a computer that has the speed to run the program, because definitely the ones in the hallways are a hell of a lot slower. I wonder if anybody uses those.… And some of the ones in the patient's room are very slow. I would like to be able to just pop in the computer, right at the patient's bedside, I mean, write the note right there, but those are just way too slow.” (General medicine hospitalist, H2) “…once you're in there it's fast, uh, if you have a good line. So rarely freezes up.” (Obstetrician, H2, on system speed via remote access) “…you need to put in username, password, and, I mean, but you have to boot it up #laughs# you know, we don't have our system necessarily up and running the whole time, so you have to sit down, turn it on, log in. So, there's a slight delay.” (Anesthesiologist, H1)
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| Functionality |
“…there's obviously things like order sets and pathways which are, which really facilitate your use. Um, if they didn't have those, it would be a problem … Um, obviously the templates are very handy.” (General medicine hospitalist, H2) “Ann Jones is admitted to the hospital with pneumonia. Well, I can take her note from yesterday, I can copy it, put it in as today's note, and everything automatically refreshes. And so that way, I can use that and just edit what I need to, depending on what the plan of the day is.” (General medicine hospitalist, H2)
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| Usability |
“I just wish it were a much more user friendly … they would say, well, there's multiple ways to do your progress note, for example.… I think most docs don't really want multiple ways to do the same thing. I think what we want is the most efficient way to do one thing, and so I wish they'd of said, here's the way you're gonna do your notes.” (General medicine hospitalist, H2) “…it's not an intuitive system … if you haven't been instructed in how to use it, it's, uh, almost impossible to sit down and, looking at icons, navigate through to get to the information that you need” (Anesthesiologist, H1) “Uh, sometimes the way the information's formatted … We're still kind of used to flipping through a [paper] chart, and then being able to pick up by Gestalt what's important. Now, this is a little different, getting used to it … Well, you just get one screen at a time, and then you have to click, while the chart you could flip through quickly.” (Rheumatologist, H1) “But the programs are very straightforward. They know that docs don't know what they're doing with computers, so they make it easy for us.” (Psychiatrist, H1)
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