Patients' satisfaction with primary heath care in kuwait after electronic medical record implementation

J Egypt Public Health Assoc. 2006;81(5-6):277-300.

Abstract

This study aimed at assessing the level of patients' satisfaction with primary heath care services after implementation of the electronic medical record system (EMR). Also, to explore the relationship of some participants' characteristics with satisfaction which are of importance in planning, managing and evaluation. A descriptive cross-sectional approach was adopted. Ten primary health care centers (out of total 78) related to the five health regions in Kuwait were randomly selected. A random sample of 200 people (at age of 18 years and above) attending the two-shift periods of the chosen centers were included. Through an exit interview, a well trained investigator interviewed them about their satisfaction with the primary heath care services provided after implementation of electronic medical record system. A structured questionnaire for measuring satisfaction was used. The response rate was 93.02% of whom 47.5% were males and 52.5% were females. The mean overall satisfaction percent score as reported by subjects was 85.6% (SD 4.9). There were statistically significant associations between mean percent satisfaction score of the participants and their age, level of education visiting the center at morning shift, and waiting less than 10 minutes before the examination. The vast majority of participants indicated that overall service at the center had greatly improved after EMR implementation. The system also helped in improvement of the physician performance, arrangement of patient's turn, dispense medication from pharmacy, written guidance of medication, accuracy and easiness of follow up for health status, time spent to retrieve medical record and that for receiving medication. However, it didn't achieve much improvement in physician selection or waiting time. The majority of interviewees (96.5%) were totally satisfied with the overall quality of service at the center, location of the center (96.5%), hours when the center is open (96.5%), thoroughness of examination and accuracy of diagnosis (97.0%), advices to avoid illness (96.0%) and outcome of medical care (97.0%). However, the lowest items of satisfaction were those related to explanation of medical procedures and tests (46.5%) and ease of seeing physician of choice (61.0%). Almost 62.0% of the interviewed persons expressed their satisfaction with overall PHC service provided after EMR implementation. The leading two items of dissatisfaction that showed by the majority of dissatisfied participants were non-compliance of physician with good practice in prescription writing (75.0%) and inability to see the same physician in every visit (72.4%). The results showed that although the overall satisfaction was relatively high, certain aspects of the service showed some degree of dissatisfaction. This study demonstrated patient acceptance and support for the electronic medical record system at the primary care setting. These findings should encourage physicians to promote the use of electronic medical record system.