From maternity paper hand-held records to electronic health records: what do women tell us about their use?
Glenda Hawley A E , Julie Hepworth B , Shelley A. Wilkinson A C D and Claire Jackson AA Australian Primary Health Care Research Institute (APHCRI) Centre of Research Excellence in Primary Health Care Microsystems, School of Medicine, Discipline of General Practice, The University of Queensland, Level 8 Health Sciences Building, Building 16/910, Royal Brisbane & Women’s Hospital, Herston, Qld 4029, Australia.
B School of Public Health & Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
C Mater Research, Mothers & Babies Theme, Mater Health Services, Raymond Terrace, South Brisbane, Qld 4101, Australia.
D Department of Nutrition and Dietetics, Mater Health Services, Raymond Terrace, South Brisbane, Qld 4101, Australia.
E Corresponding author. Email: glenda.hawley@uq.edu.au
Australian Journal of Primary Health 22(4) 339-348 https://doi.org/10.1071/PY14170
Submitted: 19 November 2014 Accepted: 2 April 2015 Published: 9 September 2015
Abstract
The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women’s experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. Fifteen women were interviewed in Phase 1 and 12 women in Phase 2. Semi-structured interviews were used for data collection, and analysed using qualitative content analysis. Four main themes were identified: (1) purpose of the record, (2) perceptions of the record; (3) content of the record, and (4) sharing the record. Findings indicate that the PHR is a well-liked maternity tool. The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use.
Additional keywords: antenatal, general practitioner (GP), Mater Shared Electronic Health Record (MSEHR), maternity, qualitative research, shared care.
References
Bernstein PS, Farinelli C, Merkatz IR (2005) Using an electronic medical record to improve communication within a prenatal care network. Obstetrics and Gynecology 105, 607–612.| Using an electronic medical record to improve communication within a prenatal care network.Crossref | GoogleScholarGoogle Scholar | 15738032PubMed |
Draper J, Field S, Thomas H, Hare MJ (1986) Should women carry their antenatal records? British Medical Journal (Clinical Research Ed.) 292, 603
| Should women carry their antenatal records?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL287jt1Ggtw%3D%3D&md5=fc4ca547dace1e3d228cf7cf1a466e3fCAS |
Eggleton M (2014, 25 June) Privacy fears curb e-health’s growth. The Australian Financial Review, p. 33.
Elbourne D, Richardson M, Chalmers I, Waterhouse I, Holt E (1987) The Newbury Maternity Care Study: a randomized controlled trial to assess a policy of women holding their own obstetric records. British Journal of Obstetrics and Gynaecology 94, 612–619.
| The Newbury Maternity Care Study: a randomized controlled trial to assess a policy of women holding their own obstetric records.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL2s3pvFGlug%3D%3D&md5=34bbd911cef3ad0650ca0e99ed139316CAS | 3304403PubMed |
Fisher B, Bhavnani V (2009) How patients use access to their full health records: a qualitative study of patients in general practice. Journal of the Royal Society of Medicine 102, 539–544.
| How patients use access to their full health records: a qualitative study of patients in general practice.Crossref | GoogleScholarGoogle Scholar | 19966130PubMed |
Greenhalgh T, Taylor R (1997) How to read a paper: papers that go beyond numbers (qualitative research). British Medical Journal (Clinical Research Ed.) 315, 740–743.
| How to read a paper: papers that go beyond numbers (qualitative research).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2svmtVersg%3D%3D&md5=ba38eec23793b58a3dd92fb11479ae41CAS |
Hamilton SG (1956) Obstetric record card for use in General Practice Practitioner. The Practitioner 176, 79–81.
Hawley G, Janamian T, Jackson C, Wilkinson S (2014) In a maternity shared-care environment, what do we know about the paper hand-held and electronic health record: a systematic literature review. BMC Pregnancy and Childbirth 14, 52
Hoerbst A, Ammenwerth E (2010) Electronic health records. Methods of Information in Medicine 49, 230–336.
Homer CSE, Davis GK, Everitt LS (1999) The introduction of a woman-held record into a hospital antenatal clinic: the bring your own records study. Australian and New Zealand Journal of Obstetrics and Gynaecology 39, 54–57.
| The introduction of a woman-held record into a hospital antenatal clinic: the bring your own records study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7pvFGhtg%3D%3D&md5=56b5cbc3d97ef856b99b957dc3d78922CAS |
Howell KE (2013) ‘An introduction to the philosophy of methodology.’ (SAGE Publications Ltd: Los Angeles)
Johanson GA, Gordon PB (2010) Initial scale development: sample size for pilot studies. Educational and Psychological Measurement 70, 394–400.
| Initial scale development: sample size for pilot studies.Crossref | GoogleScholarGoogle Scholar |
Liamputtong P (2009) ‘Qualitative research methods.’ 3rd edn. (Oxford University Press: Oxford)
Lovell A, Zander LI, James CE, Foot S, Swan AV, Reynolds A (1987) The St. Thomas’s Hospital maternity case notes study: a randomised controlled trial to assess the effects of giving expectant mothers their own maternity case notes. Paediatric and Perinatal Epidemiology 1, 57–66.
| The St. Thomas’s Hospital maternity case notes study: a randomised controlled trial to assess the effects of giving expectant mothers their own maternity case notes.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1M7ivVGgtg%3D%3D&md5=875bd1acceacea826e6c4edc351cb132CAS | 3506191PubMed |
Mahomed K, Mason E, Warndorf T (2000) Home-based mother’s record: operational feasibility, understanding and usage in a rural community in Zimbabwe. Tropical Doctor 30, 155–159.
Mater Health Services and South East Alliance of General Practice (2013) Mater Mothers’ Hospital GP Maternity Shared Care Guideline. (Mater Health Services: Brisbane)
Miller DW, (2003) Prenatal care: a strategic first step toward EMR acceptance. Journal of Healthcare Information Management 17, 47–50.
National E-Health Transitory Authority (NEHTA) (2011) NEHTA strategic plan refresh 2011/2012. Available at https://www.nehta.gov.au/component/docman/doc_download/1338-nehta-strategic-plan-2011-2012?itemid=&ref=safesearch [Verified 31 August 2015]
Pagliari C, Detmer D, Singleton P (2007) Potential of electronic personal health records. BMJ 335, 330–333.
Patton MQ (2002) ‘Qualitative research & evaluation methods.’ (Sage Publications: Thousand Oaks, CA)
Phipps H (2001) Carrying their own medical records: the perspective of pregnant women. Australian and New Zealand Journal of Obstetrics and Gynaecology 41, 398–401.
| Carrying their own medical records: the perspective of pregnant women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38%2Fmt1arsw%3D%3D&md5=df6feb4dd1c6081e3e89c62f7de02a52CAS | 11787912PubMed |
Robertson A, Creswell K, Takien A, Petrakaki D, Crowe S, Cornford T, Barber N, Avery A, Fernando B, Jacklin A, Prescott R, Klecun E, Paton J, Lichtner V, Quinn C, Ali M, Morrison Z, Jani Y, Waring J, Marsden K, Sheikh A (2010) Implementation and adoption of nationwide electronic health records in secondary care in England: a qualitative analysis of interim results from a prospective national evaluation. BMJ 341, c4564
| Implementation and adoption of nationwide electronic health records in secondary care in England: a qualitative analysis of interim results from a prospective national evaluation.Crossref | GoogleScholarGoogle Scholar | 20813822PubMed |
Rodger D, Skuse A, Wilmore M, Humphreys S, Dalton J, Flabouris M, Clifton VL (2013) Pregnant women’s use of information and communications technologies to access pregnancy-related health information in South Australia. Australian Journal of Primary Health 19, 308–312.
| Pregnant women’s use of information and communications technologies to access pregnancy-related health information in South Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3sblt1yrsg%3D%3D&md5=c2beb2737a32ed8f11044277fe8e36fbCAS | 24004661PubMed |
Schreier M (2012) ‘Qualitative content analysis in practice.’ (Sage Publications: London)
Shah PM, Selwyn BJ, Shah K, Kumar V (1993) Evaluation of the home-based maternal record: a WHO collaborative study. Bulletin of the World Health Organization 71, 535–548.
Shaw E, Howard M, Chan D, Waters H, Kaczorowski J, Price D, Zazulak J (2008) Access to web-based personalized antenatal health records for pregnant women: a randomized controlled trial. Journal of Obstetrics and Gynaecology Canada 30, 38–43.
Turner JR, Turner TG (2000) Birth in the 21st century. Notes from a visit to the New Aquatic Maternity Centre, Ostend, Belgium. Midwifery Today with International Midwife 54, 19–20.
Wäckerle A, Blöchlinger-Wegmann B, Burkhardt T, Krähenmann F, Kurmanavicius J, Zimmermann R (2010) Notes on a stick: use and acceptibility of woman-held maternity notes. European Journal of Obstetrics, Gynecology, and Reproductive Biology 153, 156–159.
| Notes on a stick: use and acceptibility of woman-held maternity notes.Crossref | GoogleScholarGoogle Scholar | 20674133PubMed |
Webster J, Forbes K, Foster S, Thomas I, Griffin A, Timms H (1996) Sharing antenatal care: client satisfaction and use of the ‘patient-held record’. Australian and New Zealand Journal of Obstetrics and Gynaecology 36, 11–14.
| Sharing antenatal care: client satisfaction and use of the ‘patient-held record’.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28zntFCjtA%3D%3D&md5=0eab25d26445995000da9e122155a3f2CAS | 8775241PubMed |
Winthereik BR (2008) Shared care and boundaries: lessons from an online maternity record. Journal of Health Organization and Management 22, 416–427.
| Shared care and boundaries: lessons from an online maternity record.Crossref | GoogleScholarGoogle Scholar | 18950076PubMed |
Yan H, Gardner R, Baier R (2012) Beyond the Focus Group Understanding Physicians’ Barriers to Electronic Medical Records. Joint Commission Journal on Quality and Patient Safety 38, 184–191.
