There is a variety of data that can be obtained by analyzing the OpenEMR clinical history system, and at this moment we have in sight the use data of an important clinic in Southern Argentina, where we installed the system 3 years ago.
We can see how much each doctor uses the system, if they do it well or with errors, and which aspects can be improved. When several users committ the same mistakes, it is obvious that a global strategy needs to be implemented.
We see that less than 10% of the system’s features are actually being used. Most users ignore the available features, and prefer typing instead of selecting options from a menu. Apparently there is no local leader that can guide the rest of the users in taking true advantage of the available system. There is no effective coordination of the data entry and processing tasks.
Use of OpenEMR in ADOS Clinic, Puerto Madryn, Argentina
We installed the system in a local server, on August 2016.
Number of patients in almost 3 years: 23589
Number of users: 117
Number of appointments: 70066
As shown by the statistics, the system has been in full use for the last 3 years. The clinic owners are still thinking about the new features that can be adopted by the user doctors and nurses.
There is always some resistance from physicians to use the new system and we must overcome it with permanent training and technical assistance. If the doctor does not ask for help we need to contact him to inquire about the system and listen to complaints or difficulties. This exchange can help us to device ways to ease system adoption, and also how to incorporate new features that will facilitate work for users. Doctors and nurses always complain about lack of time and a technical assistant can be required to assist them into computer interactions. The most common complaint is that the system is slow, difficult to use, complex or confusing. Those complaints must be dealt with separately.
The system can run faster if the server has more speed or more memory. Other times the limitation relies on the computer or smart phones used by the end users. Eight megs of memory in general are sufficient for a quick and satisfactory response. In my case I am using a solid-state hard drive that makes the response virtually immediate. The solid state disk hosts Windows and the most common files, while there is a conventional disk where the greater storage capacity is located: documents, videos and even X-ray images.
The abundance of benefits in OpenEMR can be overwhelming. In the last version you can adapt the menu of each user to the functions that he will likely use, eliminating many unnecessary, confusing features. The complexity is inherent in a system with so many benefits, but a gradual approach will often work. When the doctors see a younger collegue using interesting features of the system, they might follow the example and adopt the novelty. The complaint about confusing items is very common, but can be solved with training and documentation.
Again, the analysis of the statistics of use guides us to design easier and more accepted systems.