Exchange of health information among doctors using electronic health records: Facilitators and barriers from a sociotechnical perspective

Electronic health records (EHRs) and other computerized systems facilitate the timely exchange of patients' health information between providers across different departments and organizations. This study investigates the types and trends of electronic information exchange between doctors and the factors that impact electronic information exchange. We used data from the National Electronic Health Records Survey. Logistic regression models were run to explore the predictors of doctors' satisfaction with EHRs for information exchange. The models were adjusted to practice type and size and clinical specialty. A total of 1,524 physicians completed cross-sectional questionnaires. Low satisfaction with EHRs was correlated with the inability of providers to exchange information electronically and with difficulty in clinical care documentation. We found that doctors who perceived EHRs to improve their practices' quality, efficiency, and care coordination were more satisfied with EHRs. They also preferred EHR systems that help them reduce errors (odds ratio (OR) = 2.69, p = 0.008) and prevent duplicate test orderings (OR = 2.33, p = 0.023). Furthermore, factors such as difficulty integrating information into the system, use problems, and time consumption negatively impacted doctors' perception of EHR use. Doctors' satisfaction with EHR use was associated with meaningful functionality, namely the ability to enhance care coordination, the ability to improve information availability and quality, work environment and logistic factors, and design characteristics. Improving the design of EHR systems is essential but may not be sufficient for successful and efficient electronic information exchange between doctors. Usability more broadly with data management including external data should be prioritized.