Table 4.

Sample Patient Quotes Related to EHR Implementation

Patient VariableBefore ImplementationTransitionAfter Implementation
CE = computer experience; EHR = electronic health record; EMR = electronic medical records; NA = not applicable; PCP = primary care physician; PDA=personal digital assistant; VA = Veterans Administration
Aware of EHRI guess so, yeah (female, 65 y, some CE)
 Yes, at the nurses’ station (female, 24 y, extensive CE)I hope so. My information should be in the computer (male, 32 y, no CE)
 She does it on the computer…. She puts everything right on the computer when we’re talking (female, 46 y, extensive CE)
 Yes he is (male, 45 y, no CE)
 We’re in the 21st century. Sooner or later that paperwork is going to disappear, you know? (male, 46 y, some CE)NA
Not aware of EHRNot that I know of; is it that little pocket thing [PDA]? (female, 49 y, extensive CE)
 I have no idea; I would think so, probably (male, 45 y, little CE)I would probably say no (female, 25 y, some CE)
 I have no idea (female, 18 y, little CE)NA
General reactions to writing and/or EHRI’d rather see them writing something down than just listening… and not writing anything down (male, 41 y, some CE)
 She’s putting down what I’m telling her…everybody forgets things. So that way there, you put it down on paper, and you know, you don’t forget it. You can refer back to it. That’s why it don’t bother me at all (male, 70 y, some CE)
 She was writing what she was saying, not what I was saying…. I didn’t like what she was writing (female, about 45 y, extensive CE)The first day when he came with that [computer], you know, I didn’t say nothing. I think he knows what he’s doing…. To me, it was the same (female, 80 y, no CE)
 She was writing down what my concerns were—I mean what her concerns were because she knows me…. Well, I think everything is going computer anyway…. The computer is fine (female, 59 y, little CE)
 She does it on the computer…. She puts everything right on the computer when we’re talking…[typing is]...like a second nature thing…. Even when she’s putting things on the computer, I still feel like she’s paying attention to me (female, 46 y, extensive CE)It seemed like it would be easier to look up when she looks at my cholesterol level, you know, click on the computer—last cholesterol level…. It didn’t make me feel like she was spending her time typing, so it didn’t feel like she was taken away by, ”Hold on, I’ve got to type this.“ She just did it. So I didn’t even realize (female, 46 y, extensive CE)
Positive reactions to EHR[EHR helps] access the information a lot faster (female, 34 y, no CE)
 Obviously to me a computer is such an added benefit because you can immediately pull information (male, 54 y, extensive CE)
 They can pull it [the record] up easier (female, about 22 y, little CE)
 I think it’s useful for them to have computers…so they don’t have to keep writing everything down (female, 18 y, some CE)
 [EHR is] a lot easier instead of having to look through charts all the time…and maybe visits would go even quicker (female, 26 y, extensive CE)…they could pull the record up quicker (male, 26 y, extensive CE)
 It’s better for them. They can just get it that way without looking for files (female, 55 y, little CE)
 I rather have that [EHR] so that if I had to go to the emergency room, and they asked me things I wouldn’t know, I would say, go look it up, and everything would be there (female, 18 y, no CE)
 There ought to be less of a mound in [the landfill] someday…. I trust them [PCPs] thoroughly (female, 57 y, extensive CE)
 If you’re visiting in New Hampshire, bingo, [you can get your records/health information] over the computer …I think [it] is wise (female, 55 y, little CE)I don’t mind [the information in the computer] because they must have a system maybe to protect all the information…. It’s a good thing because like I say, you don’t have to go looking through the books. You bring everything up (male, 83 y, no CE)
 It remembers more, never forgets like people do, and paper can get lost (male, 53 y, unknown CE)
 [The] visit was smoother [with the EHR] (female, 35 y, extensive CE)
 Paperwork is out of style, and I believe the computers will be something for the world’s future…. It’s necessary…. Why should I worry about it? I’m not telling him lies. I’m just telling him I’m sick, and I see a doctor…. So I’m not worried about whatever is in the computer…. I’m not a doctor, and I came here because I trust the doctor. And that’s enough for me. Whatever he puts in there is part of his job (male, 65 y, no CE)
 The flow doesn’t change when she’s talking to me…, so like I know she’s taking notes, but I don’t really pay that much attention I guess because I’m used to it (female, 31 y, extensive CE)
 Oh, that doesn’t bother me no more than really having your medical record out on the counter. I just think that it’s faster, so she has more time to talk to me (information not available)
 I trust her [PCP]…anything I need to know she tells me about me. I mean she doesn’t hide anything from me (female, 56 y, unknown CE)
Concerns about EHRIt all depends who it’s made available to afterwards. You know we’re going through a period right now with the government. This here government type thing is really crazy, excuse me, with records and everything. And it makes me concerned that other people can get into your records... (male, 70 y, some CE)
 [Hacking] could happen, you know, I’m sure. I mean there’s a lot of hackers out there. So anything can happen (male, 36 y, extensive CE)
 I’m pretty sure the hospital has many things to make it so people can’t get at it unless it’s the right person (male, 45 y, no CE)
 Sometimes it’s OK. Sometimes it’s not because, you know, now we can break into the computers (female, 31 y, some CE)…people can take information and everything…[the] computer is another enemy…they can steal all the information from you (male, 32 y, no CE)
 I’m fine just as long as nobody else gets them besides doctors to know my information (female, 32 y, extensive CE)I just don’t want my medical records being opened up on the computer for the world to see…. Personally I would prefer the paper chart (female, 34 y, little CE)
 [EHR is] OK as long as no one breaks in and gets med info. If it’s easier for docs to pull up info they need, OK. Better than searching through paper records. [Preferred paper to EHR] (female, 29 y, extensive CE)
 Because if something goes wrong, anybody can get our information off of a computer. Like with the VA guys and stuff. Their data might have gotten stolen (female, 58 y, little CE)
 Anybody could get to those records. The point is I don’t particularly care (information not available).