Table 3. Illustrative examples of EHR's influence on MU metrics.
| Influence | Site 1 ( n = 10) | Site 2 ( n = 10) |
|---|---|---|
| Participant responses | Participant responses | |
| Door-to-doctor time | ||
| Positive | [in text] | We have the ability to look up their medical records before we even actually see the patient. I think that it helps in that regard |
| Neutral | I don't think it is changing the time people wait | There is influence and decreased time, but because of the patient assignment system, not the EHR |
| Negative | (The EHR) is probably still extending some of our metrics because it takes so much time rather than helping us | If I'm taking more time to document on patients, I'm not seeing the other patients that come in a timely manner |
| Admit decision time | ||
| Positive | Being able to see their (the patient's) whole record and know what's going on has definitely made decision making go much more quickly | Ordering what I feel is necessary, earlier in the process will decrease door to decision time quite a bit |
| Neutral | I don't think the system matters | [EHR 2] does not have much impact, but the workflow and getting laboratories and reports back does |
| Negative | – | Patient registration time to decision time is worst because [EHR 2] slows down most workflows |
| Boarding time | ||
| Positive | I think the EMR does help with boarding… I no longer take care of them. I talk to the inpatient floor upstairs, and that care has been transferred, and the inpatient team is able to actually manage them through the EMR | [EHR 2's] a helpful tool once you know how to use it. It does help me decrease the time the patient would spend in the ED |
| Neutral | [in text] | [in text] |
| Negative | – | – |
| Walk out rate | ||
| Positive | I think the EHR has probably had some impact on that as well because from the moment the patient registers, we are able to track their location and progress through the department a lot more efficiently that we did before | I guess it's better than if it was on paper |
| Neutral | I'm not sure if you can say that (EHR 1) itself is influencing walk out rate, but the fact that it is publicly appointed as part of Meaningful Use made us focus on it | I think that's actually probably the same |
| Negative | – | I think it slows things down (…) because I'm documenting through an EHR and patients are not getting back as quickly and I'm less efficient |
Abbreviations: ED, emergency department; EHR, electronic health record; EMR, electronic medical record; MU, meaningful use.