Development and Validation of a Workflow Instrument to Evaluate the Success of Electronic Health Records Implementation from a Nursing Perspective: An Exploratory and Descriptive Study.

Abstract

Introduction: Electronic medical records (EMR) have been recognized as practical tools for the improvement of the quality and safety of healthcare despite their occasional use in hospitals worldwide. Epic is an integrated software suite with functionality ranging from patient administration through systems for healthcare providers to billing systems, integration to the primary health sector, and a facility for granting patients access to their data. The implementation process is complicated; creating effective methods requires understanding users' attitudes about these information technologies. This study aimed to develop and validate a questionnaire that measures the efficacy of using workflow during the EMR (Epic) implementation. Furthermore, it describes the nurses' views on the use of quality and satisfaction of workflow.

Methods: Following a literature review, an initial pool of 57 items was generated based on the following three primary constructs: use, quality, and user satisfaction with the tool's workflow. Internal consistency reliability was assessed by calculating Cronbach's alpha and correlation coefficients for construct validity.

Results: The final scale comprised 53 items corresponding to the following five distinct factors: use of workflow, information quality, service quality, use of EMR, and user satisfaction and the influence of workflow on clinical care. The full scale was assessed, and Cronbach's alpha of 0.95 was found. The construct validity was assessed using the Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett's Test of Sphericity (0.976). Construct validity was tested twice using Exploratory Factor Analysis-Principal Component Analysis.

Conclusion: The use of workflow, quality of information, quality of service, use of EMR, and user satisfaction scale have good reliability and validity and can be used to implement technology in healthcare.