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The Experience of American Frontline Health Care Workers With Electronic Medical Records Technology During the Time of COVID-19: A Phenomenological Inquiry Following the Systems Approach.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	The Experience of American Frontline Health Care Workers With Electronic Medical Records Technology During the Time of COVID-19: A Phenomenological Inquiry Following the Systems Approach./
作者:	Cauley, Michael Richard.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
面頁冊數:	183 p.
附註:	Source: Dissertations Abstracts International, Volume: 84-12, Section: B.
Contained By:	Dissertations Abstracts International84-12B.
標題:	Bioinformatics. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30557561
ISBN:	9798379607920

The Experience of American Frontline Health Care Workers With Electronic Medical Records Technology During the Time of COVID-19: A Phenomenological Inquiry Following the Systems Approach.
Cauley, Michael Richard.

The Experience of American Frontline Health Care Workers With Electronic Medical Records Technology During the Time of COVID-19: A Phenomenological Inquiry Following the Systems Approach. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 183 p.

Source: Dissertations Abstracts International, Volume: 84-12, Section: B.

Thesis (Ph.D.)--Case Western Reserve University, 2023.

This item must not be sold to any third party vendors.

Health care workers are bound in a tension of patient care and electronic medical record (EMR) systems direr than the COVID-19 pandemic. On the one hand, clinicians value increased access to patient records; on the other, this access reflects a promise of EMR systems implementation that many clinicians still await delivery. Incentivized adoption of EMR systems included additional billing, regulation, and compliance procedures and created tension in clinician documenting practices for patient care. Through this study, I sought to understand how documentation practices introduced by EMR systems affect clinicians' feelings and dispositions of connectedness to patients.The main finding of my study is that the lingua franca of health care practice reflects two logics: a logic of intimacy in clinician decision-making and a logic of standardization in EMR systems. Between these logics, the clinician's feelings, dispositions, and experiences of providing care for the patient emerge. As a result, a tension of human connection and separation between clinician and patient occurs when feelings and dispositions from human beings are transferred through technology.My findings are from an integrated mixed-methods study. In Study 1, qualitative results of 24 health care professionals across the United States, I identified a dialectic of documenting Tension in EMR systems in the logic of intimacy and the logic of standardization. The logic of intimacy represents the clinician's commitment to helping, and the logic of standardization means management constraints of helping. Between the commitment to helping and the management constraints of helping, communication for helping emerges, which clinicians experience as documenting tension. This tension is experienced as Care Through Charting and Charting as Interference in EMR systems.In Study 2, I proposed a framework for understanding factors that lead to feelings and dispositions of clinicians and patient care through documentation practices in EMR systems. A survey was conducted with 450 respondents of factors that theoretically contribute to a greater understanding of feelings and dispositions of patient care. I noted that patient care is affected by feelings and dispositions from the practitioner toward the patient in EMR systems documentation practices. With findings from Study 1, I concluded that documentation practices in EMR systems create tension between competing logics in patient care by including human decision-making values within the systems approach: who, when, how, and what. Values are a part of the whole system, including the reason many health care providers chose their profession, a commitment to helping.Continuing this line of inquiry, I sought to identify critical organizational outcomes which are minimized and maximized because of the clinician's feelings and dispositions of connectedness to the patient through documentation practices in EMR systems. In Study 3, I found that Charting as Interference negatively affects Belonging,{A0}while clinician feelings and dispositions of Care Through Charting positively affect Work Satisfaction and Belonging.Patient care occurs within three locations across two logics: the logic of intimacy in clinician decision-making, the logic of standardization in EMR systems, and the distance between logics the clinician uses as a transitory space for decision-making. The logic of intimacy draws on human values, who, when, how, and what of human decision-making. Many clinicians choose their profession because of human values, and managing values applied to patient care requires the logic of standardization in an organization. Both logics and sources of logic, social and technical, are necessary to provide care. As a result, a sociotechnical system is created. However, a sociotechnical system introduces tension between the logics, potentially reducing clinicians' feelings of being essential to the organization.This study fills a knowledge gap by investigating how EMR systems documentation practices create tension between clinician feelings and dispositions for the patient and charting as interference. These findings can theorize and operationalize the challenge of feelings and dispositions in IS research in health care.{A0}

ISBN: 9798379607920Subjects--Topical Terms:

553671
Bioinformatics.
Subjects--Index Terms:

Health care workers

The Experience of American Frontline Health Care Workers With Electronic Medical Records Technology During the Time of COVID-19: A Phenomenological Inquiry Following the Systems Approach.
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