Health information system support for collaboration between physicians and registered nurses: National cross-sectional user experience surveys from 2010 to 2023.

BACKGROUND

In addition to storing patient data, health information systems (HISs) should advance continuity and quality of care by supporting collaboration between physicians and registered nurses (RNs). Our aim was to study how physicians and RNs experience this support and how the situation has evolved from 2010 to 2023.

METHODS

Nationwide usability-focused cross-sectional surveys were conducted among Finnish physicians in 2010, 2014, 2017, and 2021 and RNs in 2017, 2020, and 2023. For this study, we selected respondents (1807-2555 physicians and 1126-1950 RNs) working in public sector wards and outpatient clinics and using the six largest electronic health record (EHR) system brands. Eight statements related to collaboration were analyzed by professional group and study year.

RESULTS

Although both professional groups rated HIS support for collaboration and information exchange between physicians and RNs relatively positively (42-69% agreed), their experiences had not improved much over the years. Continuity of care was considered good by 34-54% of physicians and 51-58% of RNs. Half of respondents were dissatisfied with the readability of nursing documentation (52-56% of physicians and 30-37% of RNs) and support for noticing new orders (40-46% of physicians and 26-36% of RNs). Only 7-30% of all respondents felt that patient summary views provided by EHR systems helped to form an overall picture of the patient's situation; however, the proportion did improve over the years.

CONCLUSIONS

HISs were considered to better support collaboration among their own professional group than between physicians and RNs. As reviewing patient information forms a basis for decision making and high-quality care, EHR development should not only focus on ordering and documentation tools but also on securing multiprofessional utilization of data. Indeed, the varied needs of professional groups should be recognized in the early stages of the development process.