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Transition to an Electronic Health Record in Stroke Rehabilitation: Perspectives on Assessment and Workflow
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- Author / Creator
- Jhingan, Palak
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This thesis explores the transition to an Electronic Health Record (EHR) system in an inpatient stroke rehabilitation setting at Glenrose Rehabilitation Hospital (GRH), describing the perceptions and experiences of rehabilitation therapists and managers. The thesis begins with a scoping review, with the objective of examining the extent of existing literature on rehabilitation therapists’ perspectives on EHR transitions and identifying prevailing gaps in literature. This objective is achieved by systematically searching and analyzing relevant literature from electronic bibliographic databases such as Ovid MEDLINE, EMBASE, CINAHL, and SCOPUS. Due to the sparse availability of studies specifically targeting rehabilitation therapists, the review broadens its focus to include allied health professionals (AHPs). The scoping review classifies the findings as perceived facilitators and perceived barriers; and identifies the following gaps in the existing research- limited isolated studies specifically focusing on perceptions of rehabilitation professionals, a geographical concentration of research predominantly in Australia, and a gap in exploring perspectives around clinical practice. Rather, literature lays an emphasis on the usability and functionality perceptions of EHR systems.
The subsequent qualitative study seeks to fill the identified gap by exploring EHR transition perceptions on assessment and workflow, in an inpatient stroke rehabilitation setting. The study employs qualitative descriptive methods- focus groups and thematic analysis- to delve into the experiences of rehabilitation therapists and managers on transitioning to EHR. The thematic analysis is informed by the themes of E.M. Rogers’ Diffusion of Innovations (DoI) theory, and the findings are organized under DoI theory’s key technical themes—relative advantage, compatibility, complexity, trialability, and observability—and social themes—adopter categories, psychological factors, and team and organizational dynamics.
Under technical attributes, EHR offered a relative advantage and observable benefits over traditional systems in enhancing communication and information access, patient-centered goal setting and continuity of care. However, it introduced challenges like compatibility issues with existing workflows, increased documentation burdens and technical complexities. The study also illuminated the essential role of human and social factors in EHR adoption, with participant categorization into Rogers' adopter categories revealing varied staff readiness and acceptance. The transition's psychological effects, marked by resistance, anxiety, and adaptation levels, underscored the need for a supportive organizational culture with peer support and proactive leadership to facilitate EHR adoption. -
- Graduation date
- Fall 2024
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- Type of Item
- Thesis
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- Degree
- Master of Science
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- License
- This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.