1. Sockolow, Paulina S. MBA, DrPH
  2. Lehmann, Harold P. MD, PhD
  3. Weiner, Jonathan P. DrPH

Article Content

Statement of the Problem:

The impact of an electronic health record (EHR) on nurse satisfaction regarding the clinical process and patient outcomes in a gerontology setting has not been adequately evaluated.


Specific Aims:

This aim was to assess the impact of a commercial EHR on clinician satisfaction with the clinical process in a nurse-managed Program for All-inclusive Care for Elders (PACE), using the Health Information Technology Research-based Evaluation Framework (HITREF) developed for this study.


Setting and Sample:

Thirty-eight clinicians in a nurse-managed PACE were included in this study.



The methods used was evaluation case study: observation, survey, follow-up interview, and concordance of actual responses related to the evaluation criteria and expected responses based on the literature.



The EHR was not used as intended because of workflow and screen design issues. Triangulation of multiple data sources identified one statistically significant independent variable, usability associated with overall satisfaction, and seven HITREF evaluation components of interest: worth the time and effort, patient outcomes, organizational support, efficiency, complete/accurate, hardware, and team communication. Despite differences in research design, concordance of actual and expected responses reached 30%.



Using multidimensional methods enabled the "black box" of health information technology (HIT) intervention to be opened for comparability and provided information about workflow and functionality. The significant variable accounted for a sizable amount of the variation in overall satisfaction. Triangulation of responses to survey prompts and interviews indicated that nonsignificant variables may improve the model. This evaluation provides insight into nurse use of EHRs in community-based, long-term-care settings. Nurses' use will become increasingly important as HIT is used to manage the health of the growing elderly population with multiple chronic conditions.


Section Description

We are pleased to share the paper presentation abstracts from the Summer Institute in Nursing Informatics, Informatics at the Point of Care: A Barrier or a Bridge?, held at the University of Maryland School of Nursing, July 22 to 25, 2009. The program, chaired by Dr Judy Ozbolt, was a great success. Each of the following abstracts was selected for presentation by a peer-review committee.