Although the potential benefits of computer-based records have been identified in different areas of the healthcare environment, in many settings paper-based records and computer-based records are still used in parallel. In this article, emergency department (ED) staff perspectives about the use of paper- or computer-based records are presented. This was a qualitative study in which data were collected using in-depth semi-structured interviews with the ED staff. The interviews were transcribed verbatim and data were analysed using framework analysis. In total, 34 interviews were undertaken. The study identified a number of factors which might encourage or discourage the use of paper-based and computer-based records in the ED. Users also expressed their concerns and expectations. Although there is a tendency towards computerizing healthcare settings, user acceptance of technology should not be underestimated. To improve user acceptance, users’ concerns should be investigated and addressed appropriately.
Klar R.Selected impressions on the beginning of the electronic medical record and patient information. Methods of Information in Medicine2004; 43 (5); 537-42.
2.
Roukema J., Los R.K., Bleeker S.E., van Ginneken A.M., van der Lei J., Moll H.A. Paper versus computer: feasibility of an electronic medical record in general paediatrics. Paediatrics2006; 117 (1); 15-21.
3.
Laerum H.Evaluation of electronic medical records: a clinical task perspective. Doctoral thesis, Norwegian University of Science and Technology , Trondheim, 2003.
4.
Lium J.T., Tjora A., Faxvaag A.No paper, but the same routines: a qualitative exploration of experiences in two Norwegian hospitals deprived of the paper-based medical record. BMC Medical Informatics & Decision Making2008 ; 8 (2).
5.
Ammenwerth E. , Iller C., Mahler C.IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study. BMC Medical Informatics & Decision Making2006; 6 (3).
6.
Despont-Gros C., Mueller H., Lovis C.Evaluating user interactions with clinical information system: a model based on human-computer interaction models. Journal of Biomedical Informatics2005; 38 (3); 244-55.
7.
Rose A.F., Schnipper J.L., Park E.R., Poon E.G., Li Q., Middleton B.Using qualitative studies to improve the usability of an EMR. Journal of Biomedical Informatics2005; 38 (1); 51-60.
8.
Apkon M., Singhaviranon P.Impact of an electronic information system on physician workflow and data collection in the intensive care unit. Journal of Intensive Care Medicine2001; 27 (1); 122-30.
9.
Dillon A., Morris M.G.User acceptance of new information technology: theories and models . Annual Review of Information Science & Technology1996 ; 31; 3-32.
10.
Ayatollahi H.Evaluation of emergency department information systems (EDIS). PhD thesis, University of Sheffield, 2009, in preparation.
11.
van der Meijden M.J., Solen I., Hasman A., Troost J., Tange H.J.Two patient care information systems in the same hospital: beyond technical aspects. Methods of Information in Medicine2003; 42 (4); 423-7.
12.
Ammenwerth E., Mansmann U., Iller C., Eichstadter R.Factors affecting and affected by user acceptance of computer-based nursing documentation: results of a two-year study. Journal of the American Medical Informatics Association2003 ; 10 (1); 69-84.
13.
Mazzoleni M.C. , Baiardi P., Giorgi I., Franchi G., Cortesi M., Sozze F.Mutual involvement of information system, users and context: the influence on the acceptance of a hospital information system. In Masys DR ed. The Emergence of Internetable Health Care Systems That Really Work. Proceedings of AMIA Annual Fall Symposium (formerly SCAMC), Nashville, 1997, p. 876.
14.
van der Meijden M.J., Tange H., Troost J., Hasman A.Development and implementation of an EPR: how to encourage the user. International Journal of Medical Informatics2001; 64 (2-3); 173-85.
15.
Handy J., Hunter I., Whiddett R.User acceptance of inter-organizational electronic medical records . Health Informatics Journal2001; 7 (2); 103-7.
16.
Ammenwerth E. , Kaiser F., Wilhelmy I., Hofer S.Evaluation of user acceptance of information systems in health care: the value of questionnaires . In Baud R, Fieschi M, Le Beux P, Ruch P eds The New Navigators: From Professionals to Patients . Proceedings of Medical Informatics Europe (MIE 2003), St Malo, 2003.
17.
Despont-Gros C., Fabry P., Muller H., Geissbuhler A., Lovis C.User acceptance of clinical information systems: a methodological approach to identify the key dimensions allowing a reliable evaluation framework. Medinfo2004; 11 (Pt 2); 1038-42.
18.
Smith C.A., Haque S.N.Paper versus electronic documentation in complex chronic illness: a comparison . In Biomedical and Health Informatics. Proceedings of AMIA Annual Fall Symposium (formerly SCAMC) , Washington, DC, 2006, pp. 734-8.
19.
Strausberg J., Koch D., Ingenerf J., Betzler M.Comparing paper-based with electronic patient records: lessons learned during a study on diagnosis and procedures codes . Journal of the American Medical Informatics Association2003; 10 (5); 470-7.
20.
Ilie V., Courtney J.F., Van Slyke C.Paper versus electronic: challenges associated with physicians’ usage of electronic medical records. Proceedings of the 40th Hawaii International Conference on System Sciences, 3-6 January 2007, p. 142b.
21.
Amouh T., Gemo M., Macq B., Vanderdonckt J., El Gariani A., Reynaert MS, Stamatakis, L.Thys, F.Versatile clinical information system design for emergency departments . IEEE Transactions on Informations Technology in Biomedicine2005; 9 (2); 174-83.
22.
Handler J.A. , Adams J.G., Feied C.F., Gillam M., Vozenilek J., Barthell E.N., Davidson S.J.Emergency Medicine Information Technology Consensus Conference: Executive Summary. Academic Emergency Medicine2004; 11 (11); 1112-13.
23.
Thomas R.M.Blending Qualitative and Qualitative Research Methods in Theses and Dissertations . Thousand Oaks, CA: Corwin, 2003.
24.
Punch K.F.Introduction to Social Research: Qualitative and Quantitative Approaches . London: Sage, 1998.
25.
Denscombe S.M.The Good Research Guide for Small-Scale Social Research Projects. Milton Keynes: Open University Press, 2005.
26.
Ritchie J., Spencer E.Qualitative data analysis for applied policy research. In Bryman A, Burgess R G eds Analyzing Qualitative Data, pp. 173-94London: Routledge, 1994.
27.
Heeks R.Health information systems: failure, success and improvisation. International Journal of Medical Informatics2006 ; 75 (2); 125-37.
28.
Taylor T.Information management in the emergency department. Emergency Medicine Clinics of North America2004; 22 (1); 241-57.
29.
Jones M.R.Computers can land people on Mars, why can’t they get them to work in a hospital?Methods of Information in Medicine2003; 42 (4); 410-15.
