86 Chapter 6 ABSTRACT Background Numerous publications show that electronic medical records (EMR) may provide an important contribution to increasing the quality of care. There are indications that particularly the medical specialist plays an important role in the use of EMRs in hospitals. Objective The aim of this study was to examine how, and by which aspects, the relationship between EMR use and quality of care in hospitals is influenced according to medical specialists. Methods To answer this question, a qualitative study was conducted in the period August- October 2018. Semi-structured interviews of around 90 minutes were held with eleven medical specialists of eleven different Dutch hospitals. For the analysis of the answers, we used a previously published taxonomy of factors that can influence the use of EMRs. Results The professional experience of the participating medical specialists varied between 5 and 27 years. Using a previously published taxonomy, these medical specialists considered technical barriers the most significant for EMR use. The suboptimal change processes surrounding implementation were also perceived as a major barrier. A final major problem is related to the categories ‘social’, the relation with the patient and fellow care providers, and ‘psychological’, based on their personal issues, knowledge, perceptions, and ‘time’, the time required to select, implement, and learn how to use EMR systems, and subsequently enter data into the system. On the positive side, they also identified potential technical facilitators, particularly in the assured availability of information to all health care professionals involved in the care of a patient. They see promise in using EMRs for medical decision support to improve quality of care but consider these possibilities currently lacking. Conclusions The eleven medical specialists shared positive experiences of EMR use when comparing it to the formerly used paper records. The fact that involved healthcare professionals can access the patient data at any time they need itis considered important. However, in
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