Evaluating the implementation of a new electronic healthcare system in a single Trust in Northern Ireland

Introduction
This study assesses the implementation of the introduction of an electronic healthcare record (EHCR) into the South Eastern Trust (SET) in Northern Ireland.

Aims
To address the effect of the introduction of EHCR on clinical efficiency, initial implications for patient care and staff wellbeing, and to provide guidance from lessons learnt for future implementation.

Method
Doctors employed and medical students on placement within the SET were asked to complete an electronic Likert survey during the system's initial three months of implementation.

Results
There were 151 responses across 25 specialties. Overall, 81% did not experience an improvement in working efficiency. 50% of respondents anticipated that inpatient efficiency would improve with time, while 19% did not. In the outpatient clinic environment, only 25% believe that efficiency will be improved with time and adaptation. Regarding administration, 45% believe that following introduction, administrative tasks placed on doctors are disproportionate to their clinical value for patient care. 67% stated that there was less time for medical education and training.

Conclusions
Despite an initial overall negative response towards EHCR participants have a positive attitude towards its potential to improve patient care. Concerns relating to system usability and administrative burden imposed by Epic on senior staff remain apparent throughout the study. 'A perfect system would have doctors freed up to do what we are trained to do'. Usability issues were identified as contributory to this dissatisfaction. Inadequate training was identified as a factor which made adaptation more challenging. This in particular is a consideration for those trusts yet to implement Epic.