Article Text
Abstract
Introduction Many GUM clinics have shifted from paper to Electronic Patient Records (EPR). While paper has limitations, its natural functionality – e.g. free-form writing, sketching and page-turning – is intuitive and easy to exploit. EPR promises so much, but how easy or intuitive is it in current clinical GUM practice?
Methods A mixed methods paper survey asking GUM clinicians about the EPR they use.
Part one asked about usability and function with fourteen 7-point Likert-scale items. Part two guided respondents to describe qualitatively how EPR affected their sense of the clinical consultation.
Results Out of 33 surveys distributed, 28 were returned (85%) by mixed staff groups from 3 clinics using the same EPR.
Likert-scale items underwent chi-square analysis after collapsing responses into positive and negative groups. All 14 items were negatively skewed away from neutral; 8 of these were significant (p<0.05): history overview, accuracy with multiple visits, getting lost, mirroring clinical reality, use of graphics, amount of clicking, searchability and support of clinical practice. Further analysis will explore this deviation from neutral.
Qualitative responses described frustration, reduced competence/autonomy, interrupted flow, poor eye contact, poor history overview, repeated questions - particularly with symptomatic patients or with multiple episodes of care.
Discussion There is dissatisfaction with this EPR system, both in the way it functions and its impact on the clinician-patient consultation. Further research is warranted to assess the extent of these issues with other GUM EPR systems, and to explore ways of engaging with clinical information that help rather than hinder clinical performance.