Evaluating the impact of electronic health records on nurse clinical process at two community health sites.

We conducted two mixed methods studies in community-based health care settings to examine EHR use among nurses documenting direct patient care and EHR impact on nurse satisfaction. Quantitative methods included documentation time-to-completion data and a clinician satisfaction survey. Qualitative methods included observations and follow-up interviews. Qualitative data was merged with the quantitative data by comparing findings along themes. Results indicated nurses increased the number and timeliness of notes documented. Nurse use of the EHR as intended varied between the research sites. Barriers to EHR use included cumbersome functionalities that impacted nurse efficiency, lack of interoperability, and hardware issues. Facilitators to adoption included functionalities that provided memory prompts during the care process and enabled nurses to communicate about patient care. Interpretation of findings underscores the importance of the interaction of workflow, EHR functionality, and usability to impact nurse satisfaction, efficiency, and use of the EHR.