Any studies on productivity changes after adopting OpenMRS or Bahmni?

jasonmfry · July 26, 2019, 7:49am

I’m from the USA where we have done a poor job implementing EHRs over the last 10-15 years. Maybe other countries have done better, but all my research has been tinted by our history in the USA. There have been numerous studies in the US that have indicated that EHRs reduce productivity and increase frustration. I’ve linked a few studies below.

So does anyone know of any similar studies focused on OpenMRS or Bahmni? We’re considering these tools for a very large hospital that will see thousands of patients per day, and even more via telehealth.

https://ehrintelligence.com/news/61-of-physicians-say-ehr-systems-reduce-clinical-efficiency

ncbi.nlm.nih.gov

Implementing electronic health records (EHRs): health care provider perceptions before and after transition from a local basic EHR to a commercial comprehensive EHR.

M Krousel-Wood, AB McCoy, C Ahia, EW Holt, DN Trapani, Q Luo, EG Price-Haywood, EJ Thomas, DF Sittig and RV Milani, Journal of the American Medical Informatics Association : JAMIA, Jun 2018 01

We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR.Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health care providers before (baseline) and at 6-12 months (short term) and 12-24 months (long term) after the transition. We analyzed 32 items for the overall group and by practice setting, provider age, and specialty using separate multivariable-adjusted random effects logistic regression models.A total of 223 providers completed all 3 surveys (30% response rate): 85.6% had outpatient practices, 56.5% were >45 years old, and 23.8% were primary care providers. The percentage of providers with positive perceptions significantly increased from baseline to long-term follow-up for patient communication, hospital transitions - access to clinical information, preventive care delivery, preventive care prompt, preventive lab prompt, satisfaction with system reliability, and sharing medical information (P < .05 for each). The percentage of providers with positive perceptions significantly decreased over time for overall satisfaction, productivity, better patient care, clinical decision quality, easy access to patient information, monitoring patients, more time for patients, coordination of care, computer access, adequate resources, and satisfaction with ease of use (P < 0.05 for each). Results varied by subgroup.After a transition to a commercial comprehensive EHR, items with significant increases and significant decreases in the percentage of providers with positive perceptions of EHR benefit were identified, overall and by subgroup.

jesplana · July 30, 2019, 9:05am

@jasonmfry I’m sure the challenges are the same regardless of the system used. Here’s a link to a paper that talks about the experience in PoC implementation of OpenMRS in a PHC in Malawi: http://ebooks.iospress.nl/publication/13402 (@darius was one of the authors and I’m sure he’d be able to point you to other studies.)

Additionally, here’s a link to Dr. Jerry Douglas (https://www.dbmi.pitt.edu/person/gerald-douglas-phd) who published plenty of papers regarding the use of an EMR system in Malawi.

John