Features and frequency of use of electronic health records in primary care across 20 countries: a cross-sectional study

G. Kerr, N Kulshreshtha, G. Greenfield, E Li, T Beaney, B.W.J. Hayhoe, J. Car, A. Claveria, C. Collins, S.M. Espitia, M.J. Fernandez, G Gusso, K. Hoedebecke, R.D. Hoffman, GREG IRVING, G. Jimenez, L. Laranjo, V. Lazic, H. Linger, E. MemarianK. Nessler, B.G. O'Neill, D. Peter, A. Serafini, M. Ungan, A. Majeed, A.L. Neves

Research output: Contribution to journalArticle (journal)peer-review

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Abstract

Objectives: Variation exists in the capabilities of electronic healthcare records (EHRs) systems and the frequency of their use by primary care physicians (PCPs) from different settings. We aimed to examine the factors associated with everyday EHRs use by PCPs, characterise the EHRs features available to PCPs, and to identify the impact of practice settings on feature availability.

Study design: Cross-sectional study.

Methods: PCPs from 20 countries completed cross-sectional online survey between June and September 2020. Responses which reported frequency of EHRs use were retained. Associations between everyday EHRs use and PCP and practice factors (country, urbanicity, and digital maturity) were explored using multivariable logistic regression analyses. The effect of practice factors on the variation in availability of ten EHRs features was estimated using Cramer's V.

Results: Responses from 1520 out of 1605 PCPs surveyed (94·7%) were retained. Everyday EHRs use was reported by 91·2% of PCPs. Everyday EHRs use was associated with PCPs working >28 h per week, having more years of experience using EHRs, country of employment, and higher digital maturity. EHRs features concerning entering, and retrieving data were available to most PCPs. Few PCPs reported having access to tools for 'interactive patient education' (37·3%) or 'home monitoring and self-testing of chronic conditions' (34·3%). Country of practice was associated with availability of all EHRs features (Cramer's V range: 0·2-0·6), particularly with availability of tools enabling patient EHRs access (Cramer's V: 0·6, P < 0.0001). Greater feature availability of EHRs features was observed with greater digital maturity.

Conclusions: EHRs features intended for patient use were uncommon across countries and levels of digital maturity. Systems-level research is necessary to identify the country-specific barriers impeding the implementation of EHRs features in primary care, particularly of EHRs features enabling patient interaction with EHRs, to develop strategies to improve systems-wide EHRs use.
Original languageEnglish
Pages (from-to)45-53
JournalPublic Health
Early online date6 Jun 2024
DOIs
Publication statusPublished - 6 Jun 2024

Keywords

  • Digital Health
  • Primary Care
  • Electornic health records
  • Quality of care
  • Virtual Care
  • EHRs
  • Telemedicine

Research Institutes

  • Health Research Institute

Research Centres

  • Edge Hill Primary and Integrated Care Research Centre

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