The Effect of the Electronic Health Record on Interprofessional Practice: A Systematic Review

Samantha T Robertson; Ingrid C M Rosbergen; Andrew Burton-Jones; Rohan S Grimley; Sandra G Brauer

doi:10.1055/s-0042-1748855

The Effect of the Electronic Health Record on Interprofessional Practice: A Systematic Review

Appl Clin Inform. 2022 May;13(3):541-559. doi: 10.1055/s-0042-1748855. Epub 2022 Jun 1.

Authors

Samantha T Robertson^{1

2

3}, Ingrid C M Rosbergen^{4

5}, Andrew Burton-Jones⁶, Rohan S Grimley^{2

7}, Sandra G Brauer¹

Affiliations

¹ School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
² Sunshine Coast Hospital and Health Service, Sunshine Coast University Hospital, Birtinya, Queensland, Australia.
³ Digital Health CRC, Sydney, New South Wales, Australia.
⁴ Surgical Treatment and Rehabilitation Service (STARS), School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
⁵ Surgical Treatment and Rehabilitation Service (STARS), Metro North Hospital and Health Service, Herston, Brisbane, Australia.
⁶ School of Business, University of Queensland, Brisbane, Australia.
⁷ Sunshine Coast Clinical School, School of Medicine, University of Queensland, Brisbane, Australia.

Abstract

Background: Interprofessional practice and teamwork are critical components to patient care in a complex hospital environment. The implementation of electronic health records (EHRs) in the hospital environment has brought major change to clinical practice for clinicians which could impact interprofessional practice.

Objectives: The aim of the study is to identify, describe, and evaluate studies on the effect of an EHR or modification/enhancement to an EHR on interprofessional practice in a hospital setting.

Methods: Seven databases were searched including PubMed, Scopus, Web of Science, CINAHL, Cochrane, EMBASE, and ACM Digital Library until November 2021. Subject heading and title/abstract searches were undertaken for three search concepts: "interprofessional" and "electronic health records" and "hospital, personnel." No date limits were applied. The search generated 5,400 publications and after duplicates were removed, 3,255 remained for title/abstract screening. Seventeen studies met the inclusion criteria and were included in this review. Risk of bias was quantified using the Quality Assessment Tool for Studies with Diverse Designs. A narrative synthesis of the findings was completed based on type of intervention and outcome measures which included: communication, coordination, collaboration, and teamwork.

Results: The majority of publications were observational studies and of low research quality. Most studies reported on outcomes of communication and coordination, with few studies investigating collaboration or teamwork. Studies investigating the EHR demonstrated mostly negative or no effects on interprofessional practice (23/31 outcomes; 74%) in comparison to studies investigating EHR enhancements which showed more positive results (20/28 outcomes; 71%). Common concepts identified throughout the studies demonstrated mixed results: sharing of information, visibility of information, closed-loop feedback, decision support, and workflow disruption.

Conclusion: There were mixed effects of the EHR and EHR enhancements on all outcomes of interprofessional practice, however, EHR enhancements demonstrated more positive effects than the EHR alone. Few EHR studies investigated the effect on teamwork and collaboration.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Communication*
Electronic Health Records*
Hospitals
Humans

Grants and funding

Funding This research was supported by the Digital Health CRC and Queensland Health research grant “Bringing Digital Excellence to Clinical Excellence: Leading Digital Excellence in Queensland Health.” Digital Health CRC Limited is funded under the Commonwealth Government's Cooperative Research Centres Program.