Usage Pattern Differences and Similarities of Mobile Electronic Medical Records Among Health Care Providers

Yura Lee; Yu Rang Park; Junetae Kim; Jeong Hoon Kim; Woo Sung Kim; Jae-Ho Lee

doi:10.2196/mhealth.8855

Usage Pattern Differences and Similarities of Mobile Electronic Medical Records Among Health Care Providers

JMIR Mhealth Uhealth. 2017 Dec 13;5(12):e178. doi: 10.2196/mhealth.8855.

Authors

Yura Lee^#¹, Yu Rang Park^#^{1

2

3}, Junetae Kim⁴, Jeong Hoon Kim⁵, Woo Sung Kim^{1

6}, Jae-Ho Lee^{1

7}

Affiliations

¹ Department of Biomedical Informatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic Of Korea.
² Clinical Research Center, Asan Medical Center, Seoul, Republic Of Korea.
³ Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic Of Korea.
⁴ School of Management Engineering, Korea Advanced Institute of Science and Technology, Seoul, Republic Of Korea.
⁵ Medical Information Office, Asan Medical Center, Seoul, Republic Of Korea.
⁶ Department of Pulmonary & Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic Of Korea.
⁷ Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic Of Korea.

^# Contributed equally.

Abstract

Background: Recently, many hospitals have introduced mobile electronic medical records (mEMRs). Although numerous studies have been published on the usability or usage patterns of mEMRs through user surveys, investigations based on the real data usage are lacking.

Objective: Asan Medical Center, a tertiary hospital in Seoul, Korea, implemented an mEMR program in 2010. On the basis of the mEMR usage log data collected over a period of 4.5 years, we aimed to identify a usage pattern and trends in accordance with user occupation and to disseminate the factors that make the mEMR more effective and efficient.

Methods: The mEMR log data were collected from March 2012 to August 2016. Descriptive analyses were completed according to user occupation, access time, services, and wireless network type. Specifically, analyses targeted were as follows: (1) the status of the mEMR usage and distribution of users, (2) trends in the number of users and usage amount, (3) 24-hour usage patterns, and (4) trends in service usage based on user occupations. Linear regressions were performed to model the relationship between the time, access frequency, and the number of users. The differences between the user occupations were examined using Student t tests for categorical variables.

Results: Approximately two-thirds of the doctors and nurses used the mEMR. The number of logs studied was 7,144,459. Among 3859 users, 2333 (60.46%) users were nurses and 1102 (28.56%) users were doctors. On average, the mEMR was used 1044 times by 438 users per day. The number of users and amount of access logs have significantly increased since 2012 (P<.001). Nurses used the mEMR 3 times more often than doctors. The use of mEMR by nurses increased by an annual average of 51.5%, but use by doctors decreased by an annual average of 7.7%. For doctors, the peak usage periods were observed during 08:00 to 09:00 and 17:00 to 18:00, which were coincident with the beginning of ward rounds. Conversely, the peak usage periods for the nurses were observed during 05:00 to 06:00, 12:00 to 13:00, and 20:00 to 21:00, which effectively occurred 1 or 2 hours before handover. In more than 80% of all cases, the mEMR was accessed via a nonhospital wireless network.

Conclusions: The usage patterns of the mEMR differed between doctors and nurses according to their different workflows. In both occupations, mEMR was highly used when personal computer access was limited and the need for patient information was high, such as during ward rounds or handover periods.

Keywords: communication; electronic health records; mobile applications; nurses; patient handoff; physicians; rounds.

©Yura Lee, Yu Rang Park, Junetae Kim, Jeong Hoon Kim, Woo Sung Kim, Jae-Ho Lee. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 13.12.2017.