Developing a theoretical model and questionnaire survey instrument to measure the success of electronic health records in residential aged care

PLoS One. 2018 Jan 9;13(1):e0190749. doi: 10.1371/journal.pone.0190749. eCollection 2018.

Abstract

Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes. The proposed research model incorporates six variables in the reformulated DeLone and McLean information systems success model: system quality, information quality, service quality, use, user satisfaction and net benefits. Two variables training and self-efficacy were also incorporated into the model. A questionnaire survey instrument was designed to measure the eight variables in the model. After a pilot test, the measurement scale was used to collect data from 243 nursing staff members in 10 residential aged care homes belonging to three management groups in Australia. Partial least squares path modeling was conducted to validate the model. The validated EHR systems success model predicts the impact of the four antecedent variables-training, self-efficacy, system quality and information quality-on the net benefits, the indicator of EHR systems success, through the intermittent variables use and user satisfaction. A 24-item measurement scale was developed to quantitatively evaluate the performance of an EHR system. The parsimonious EHR systems success model and the measurement scale can be used to benchmark EHR systems success across organizations and units and over time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Electronic Health Records / standards*
  • Homes for the Aged / organization & administration*
  • Models, Theoretical*
  • Surveys and Questionnaires*

Grants and funding

PY received the funds from the following funding bodies: Australia Research Council Industry Linkage Grant Scheme (Project ID: LP0882430) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript (http://www.arc.gov.au/linkage-projects); Illawarra Retirement Trust had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript (http://www.irt.org.au/); RSL Care responded to the questionnaire (http://www.rslcare.com.au/); Uniting responded to the questionnaire (https://uniting.org/); Warrigal Care responded to the questionnaire (http://www.warrigal.com.au/); Aged and Community Care Services Australia had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript (http://www.agedcare.org.au/).