How do different health record systems affect home health care? : a cross-sectional study of electronic- versus manual documentation system

Abstract

Objective: To investigate electronic health record (EHR) systems compared to manual systems (MS) in home health care and how documentation and reporting activities are impacted regarding time use, variation, and accuracy. Methods: This is a cross-sectional study of two municipalities (M1 and M2) that use statistical process control charts and interview with caregivers to discuss the issue. Regarding reporting, 309 observations were used for the control charts in M1 and 572 for those in M2. Concerning documentation, 831 observations were used for M1 and 572 for M2. In addition, interviews were conducted with four caregivers from each municipality. Results: The municipality with EHR system use 3% of their total time for documentation and 7% for reporting. The municipality with the MS uses 7% of their total time in documentation and 12% for reporting. There is less variation in the charts for the municipality with the EHR system, than for the municipality using an MS. Conclusion: The municipality using the EHR system uses less time for documentation and reporting than the other municipality. This is probably due to the standardization of information in M1, and that M2 needs to record documentation twice. The standardization arising from EHR use system may cause less variation in the process than the MS, but less variation might also negatively affect information accuracy. Reduced time for oral reporting also affects information accuracy. Keywords: statistical process control, variation, documentation accuracy, home health care, electronic health records