Allied health professionals' experiences and lessons learned in response to a big bang electronic medical record implementation: A prospective observational study.

Introduction: There is limited evidence describing the impact of electronic medical record (EMR) implementation on allied health professionals' acceptance, expectations, and work efficiencies. This study aims to: A) identify clinician expectations and factors that influence EMR acceptance; B) evaluate perceived usability, technology proficiency and satisfaction; and C) assess the impact of EMR big bang implementation on allied health workflows at three Australian tertiary hospitals.

Methods: Repeated measures study pre and six-months post EMR implementation. User acceptance was evaluated with online surveys: Unified Theory of Acceptance and Use of Technology (pre), System Usability Scale and open-ended questions (post). A four-hour time-motion study evaluated changes in allied health inpatient workflows.

Results: Surveys were completed by 224 allied health clinicians (47% response rate) pre, and 196 (41%) post-implementation. Pre-implementation, 96% of respondents felt using the EMR was a good idea and they would find it useful. Six-months post-implementation 88% liked interacting with the EMR. 64% found it easy to use and most didn't require technical support (78%). While 68% of participants felt very confident, 51% believed they were not using the EMR's full potential. Post-implementation half of participants agreed significant upskilling was required and that EMR workflows were not quick to learn. Live demonstrations were considered the most helpful activity prior to training; hands-on practice in the training environment and superuser support were invaluable preparing for and during go-live. Time-motion data (mean difference (MD) (95% CI)) indicated that following implementation participants spent 2.27% (-3.53, 8.09, p = 0.731) more time in clinical tasks. More time was spent performing clinical documentation (5.39% (1.98, 8.8), p = 0.002).

Conclusions: Many factors can impact allied health professional's adoption of a new EMR. Institution-wide, simultaneous big bang EMR implementation, with strong allied health leadership, can lead to positive benefits, particularly in user experience. Ongoing evaluation will drive future improvements.