CONHI Faculty Key Contributors to Texas Report on Nurses' Experiences Using their EHRs

Wednesday, Nov 17, 2021

portraits of Dr. Cynthia Plonien and Dr. Mari Tietze

Several technological advancements have contributed to the continuous transformation of the healthcare industry. The documentation of patient data and care have been facilitated with the use of electronic health records (EHRs). In 2014, a statewide survey reported on Texas nurses’ experiences with EHRs. The data was used to better understand EHRs within the nursing field. In 2020, the statewide survey was repeated, and the results were compared with the 2014 report.

The report was generated from the work of a collaborative Health Informatics Technology (HIT) Committee comprised of representatives between Texas Nurses Association (TNA) and the Texas Organization for Nursing Leadership (TONL). UTA’s College of Nursing and Health Innovation (CONHI) faculty members Dr. Cynthia Plonien and Dr. Mari Tietze had the opportunity to contribute to the 2020 report.

This second statewide report of nurses' experiences using EHRs is now published and publicly available on TNA’s website. Over 1,150 nurses participated in the development of the report, providing both quantitative ratings of their experiences and over 300 qualitative, “in their own words,” comments about their experiences.

“The report is intended as a platform for discovery of knowledge, which builds to be added from future studies and applications. Health care executives, chief nursing executives, legislators, information technology professionals, EHR suppliers, nurses, other clinical healthcare professionals [e.g., OT, PT, etc.], and students, are encouraged to read, share and utilize the information found in the reports to improve the use of EHR's in the practice of nursing, other clinical healthcare professions, and the care of patients," said Dr. Plonien, director of the Graduate Program for Nursing Administration, clinical associate professor, as well as committee representative, chair of communications and board member of TONL.

The report highlights the positive and negative nurse experiences trends in nurses' knowledge of EHR functionality/purpose, and the competency levels for those involved in implementing EHRs. According to Dr. Mari Tietze, the Myrna R. Pickard endowed professor in CONHI and one of the lead researchers on the team, “This report reflects one of the few research studies that account for the functionality of the nurse’s EHR when measuring user satisfaction. A system that is not functional/useful to the nurse is not likely to yield a high satisfaction rating and that is important to know when interpreting results.” 

The main findings in the report include:

  • Level of EHR use satisfaction of nurses, accounting for the EHR functionality/useability and comparison in that rating between the 2014 and the 2020 surveys
  • Nurses’ knowledge of the functionality features of their EHRs and comparison between 2014 and 2020 surveys
  • Anecdotal comments from 300+ nurses and the associated themes that emerged -- Information System Design, Professional Ethics, Patient Care Quality/Standards, and Organizational Culture/Social Justice are the four major themes.

Those involved in the report will continue to study the impact of EHRs on nursing practice in Texas. The HIT committee members are on a mission to use these results to further develop technology toolkits and learning modules available at the TNA and TONL website, to carryout recommendations associated with key stakeholders, and continue monitoring the trends. 

The 2020 report concludes that, “Texas is now in a unique position to help inform national strategies for improving EHRs and other point of care technology to optimize these systems for nurses practicing within interprofessional teams.”

-Written by Cynthia Plonien, Mari Tietze and Madeline Perez
College of Nursing and Health Innovation