Exploring Healthcare Professionals’ Perspectives on Electronic Medical Records: A Qualitative Study

Abstract

Electronic Medical Records (EMRs) have the potential to enhance decision-making in the healthcare sector. However, healthcare providers encounter various challenges when using computer-based systems such as EMRs in clinical decision-making. This study explores healthcare professionals’ experiences with EMR usage through a qualitative approach. A total of 78 interviews were conducted, leading to the identification of four key themes: (1) healthcare professionals’ engagement with EMR systems, (2) job performance, (3) collaboration among healthcare professionals, and (4) quality of care and patient satisfaction. The findings provide valuable insights for researchers and practitioners, including policymakers, senior management, and information technology professionals, to inform strategies for optimising EMR implementation and adoption.

1. Introduction

We are living in the midst of an information revolution where computer-based and internet-based technologies are transforming every aspect of commerce and culture, significantly accelerating the speed of transactions. However, such revolutions are rarely seamless. While some industries, such as entertainment and logistics, have readily embraced computerisation to enhance their operations, others—most notably healthcare—have been more reluctant to adopt these advancements. Previous literature has extensively examined technology adoption across various sectors, with particular attention to user engagement [1,2]. Several researchers have also investigated technology adoption in the healthcare domain and other organisational contexts, emphasising the need to understand both the obstacles to implementation and how users come to accept these technologies over time [3,4,5,6,7,8]. Many healthcare providers continue to rely on pre-computer and pre-internet technologies, such as fax machines, for information transfer [9,10,11].

Various applications of Health Information Technology (HIT) are utilised by medical practices and healthcare providers, including personal health records [12], Electronic Medical Records (EMRs) [13,14,15], and Computerised Physician Order Entry (CPOE) systems [16,17]. EMRs are computerised systems designed to collect, store, and display patient information [18]. For consistency, this paper adopts the term Electronic Medical Records (EMRs) to refer to these systems. Other terms, such as Electronic Health Records (EHRs), are considered synonymous within this context.

According to the current literature [19,20,21], EMR systems have provided significant benefits to the healthcare sector. In the United States, the implementation of EMRs across public and private hospitals has led to estimated annual savings of approximately $81 billion [20]. To encourage EMR adoption and actual system use, the US government introduced the HITECH Act, which allocated financial resources to support this initiative [22]. Nearly $17 billion was invested in the project, with eligible healthcare providers receiving up to $41,000 within the first five years of demonstrating meaningful EMR use. Furthermore, several countries, including England, Australia, New Zealand, Canada, China, and Japan, have been advancing EMR adoption efforts [12,23,24,25]. The continued global commitment to implementing EMR systems underscores their positive impact on healthcare sectors worldwide.

EMRs address several limitations of paper-based systems, including lost requests, illegible handwriting, and workflow inefficiencies [26,27,28,29,30]. Electronic Medical Records (EMRs) facilitate the organisation of health-related information in various formats, allowing healthcare professionals to interpret data more effectively and make well-informed clinical decisions [31]. Moreover, EMRs contribute to cost reduction in healthcare by providing rapid access to patient health records, including laboratory results, medical imaging reports, and discharge summaries [9,20,32,33].

A substantial body of research has demonstrated the benefits of EMRs in healthcare, including improvements in efficiency, data accuracy, and clinical decision-making [18,20,34,35,36]. However, despite these advantages, studies indicate that EMR adoption has not progressed as expected, with implementation challenges persisting across various healthcare settings [37,38,39,40]. For instance, only 1.5% of hospitals in the United States have implemented a comprehensive EMR system, while just 7.6% have adopted basic EMR systems [41,42]. In 2015, the US government allocated $11 billion to the Defense Healthcare Management Systems Modernisation project. However, this Pentagon-led healthcare record system was reported to be obsolete even before its completion [11]. The system was designed to create an idealised framework for “seamless” information exchange between the Department of Defense, the Department of Veterans Affairs, and private-sector healthcare providers. Beyond the challenges of EMR adoption, Health Information Technology (HIT) applications introduce additional complexities for healthcare professionals, including the need for extensive training, ethical and security concerns, compatibility and interoperability issues, and disruptions to established workflows [43,44].

Additionally, Yoshida et al. [45] examined the experiences of EMR users and assessed the effectiveness of Japanese government policies in encouraging healthcare providers to adopt EMRs. Their study found that EMR adoption rates varied by hospital size, with 51.5% adoption in 822 large hospitals, 27.3% in 1832 medium-sized hospitals, and 13.5% in smaller healthcare facilities across Japan. The authors concluded that government-provided financial incentives were the primary factor driving EMR adoption in larger hospitals. The New South Wales (NSW) region in Australia has significantly expanded its Electronic Medical Record (EMR) implementation across the state. The existing electronic medical record system (eMR2) is currently used in more than 90% of NSW public hospitals [46]. However, Australia as a whole lags behind other Organisation for Economic Co-operation and Development (OECD) countries in adopting eHealth technology. A 2021 OECD survey of 27 countries revealed a growing adoption of electronic health records (EHRs), but system fragmentation remains a concern: only 15 countries have a nationally implemented system [47].

Moreover, in developing countries, Shu et al. [48] examined users’ perceptions of implementing medical record systems in China’s tertiary hospitals. Their study found that the adoption of Electronic Health Records (EHRs) for clinical information remained relatively low. Similarly, Cherry et al. [49] explored the experiences of early EMR users in long-term care facilities. Their findings indicated that employees who regularly used these systems generally had positive experiences, with operational improvements observed in areas such as better access to resident information, cost savings, enhanced documentation accuracy, and the adoption of evidence-based practices.

Despite the widespread efforts to implement EMRs across healthcare systems worldwide, adoption remains inconsistent due to various technological, organisational, and user-related challenges. While previous studies have extensively examined EMR adoption barriers and facilitators, limited research has explored how these systems impact real-world clinical workflows, interprofessional collaboration, and patient care outcomes from the perspective of healthcare professionals. Moreover, most existing studies focus on quantitative analyses, leaving a gap in qualitative insights that could offer deeper, context-specific understanding. This study aims to bridge this gap by employing a phenomenological approach to explore healthcare professionals’ lived experiences with EMRs in two large Australian hospitals.

Specifically, this study seeks to answer the following research questions:

• How do healthcare professionals perceive the impact of EMRs on their daily workflows and job performance?
• What are the key facilitators and barriers to EMR adoption among healthcare professionals?
• How does EMR usage influence interprofessional collaboration and patient care outcomes?

By addressing these questions, this research contributes to a deeper understanding of EMR usability and adoption challenges, providing insights for healthcare administrators, policymakers, and technology developers.

Assessing healthcare professionals’ perceptions of EMR usage and its impact on the quality and safety of patient care is essential [50]. In response to this need, the present study explores healthcare professionals’ experiences with EMR systems. A phenomenological approach was applied to examine EMR user experiences in two large hospitals in Queensland, Australia. Semi-structured and open-ended interviews were conducted to gain insights into healthcare professionals’ perceptions of EMR usage. This qualitative approach enabled researchers to uncover unexpected and potentially valuable information while providing deeper explanations of the factors influencing EMR adoption.

2. Related Works

The adoption and integration of Electronic Health Records (EHRs) into healthcare systems have been extensively studied in recent years. Research has highlighted both the benefits and challenges of EHR implementation, with a particular focus on healthcare professionals’ perspectives and the impact on clinical workflows.

The adoption of Electronic Medical Records (EMRs) has been extensively studied, revealing a complex interplay of factors influencing their implementation. Systematic reviews have identified key barriers to EMR adoption, including high initial costs, technical challenges, insufficient technical support, and resistance to change among healthcare providers. For instance, a comprehensive review highlighted that despite incentives, the initial financial investment remains a significant obstacle for many institutions [51]. Usability issues have also been a prominent concern. Studies indicate that while EMRs can enhance care coordination and data accuracy, they often introduce new stressors, such as increased documentation time and workflow disruptions, contributing to physician burnout. A study focusing on primary care settings found that the demands of EMR systems have become a notable contributor to professional fatigue [52].

In the context of low- and middle-income countries, additional challenges to EMR adoption have been identified, such as poor infrastructure, a lack of management commitment, and issues with interoperability. A systematic review focusing on these regions emphasised that inadequate support and experience further hinder effective implementation [53]. Furthermore, the relationship between EMR usability and physician workload has been explored, revealing that poor system design can lead to increased task load and burnout. Improving EMR usability is essential to alleviate these issues and enhance physician well-being [54].

A mixed-method study conducted in Ghana examined healthcare professionals’ perceptions of EHR systems. The findings revealed that 80.99% of participants viewed EHRs as beneficial, citing enhancements in workflow processes and patient care. However, concerns were raised regarding unstable internet connectivity, power supply issues, and patient privacy [55]. Similarly, a qualitative interview study within the National Health Service (NHS) in England explored the perspectives of Chief Clinical Information Officers (CCIOs) on EHR interoperability. Participants reported that limited interoperability led to data fragmentation, negatively impacting patient safety and care coordination. The study underscored the need for standardised systems to facilitate seamless data sharing [56].

In Southwest Ethiopia, a study employing the Unified Theory of Acceptance and Use of Technology 3 (UTAUT3) model investigated healthcare professionals’ behavioural intentions toward EHR adoption. The results indicated that performance expectancy, personal innovativeness, and attitude significantly influenced adoption intentions. Additionally, factors such as technology anxiety and social influence played a crucial role, with gender acting as a moderating variable [57]. A US-based multi-site qualitative study assessed organisational strategies supporting EHR transitions. Key recommendations included personalised training, internal support structures, workload adjustments during transitions, and sustained investment to address emerging challenges [58].

In Saudi Arabia, a qualitative study examined large-scale EHR implementation in primary healthcare centres. The research identified infrastructure, technical support, and user acceptance as critical factors for successful implementation. The study highlighted that previous implementation failures were primarily due to deficiencies in these areas, underscoring their importance in future initiatives [59]. Additionally, a mixed-methods study protocol investigated the impact of EHRs on interprofessional collaboration and clinical workflows. Preliminary findings suggested that while EHRs streamline specific processes, they also introduce challenges related to communication and workflow integration [60].

Recent studies have also investigated the impact of EHR adoption on healthcare providers’ well-being. A qualitative study highlighted that while EHRs enhance communication and information sharing, they can also contribute to increased administrative burdens and workplace stress among medical staff. Participants reported that the anticipated introduction of EHRs raised concerns about their well-being and stress levels [61]. Furthermore, research has explored patient and caregiver perceptions of EHR interoperability. A focus group study within the NHS found that patients highly value the ability to access and share their health information electronically. However, concerns were raised regarding data fragmentation and its potential impact on care quality, underscoring the need for improved interoperability to enhance patient experiences [62]. These studies provide a critical foundation for understanding both the advantages and challenges of EMR adoption. Building upon this body of work, the present study examines the nuanced experiences of healthcare professionals within the Australian context, offering practical insights for enhancing EMR usability and implementation. These insights align with the findings of this study, which examines healthcare professionals’ experiences with EMRs in an Australian context.

These recent studies highlight the multifaceted challenges and considerations involved in EHR adoption. By building on prior research, this study contributes to a deeper understanding of the nuanced challenges and opportunities associated with EMR adoption, offering valuable implications for policymakers, hospital administrators, and technology developers aiming to optimise EMR usability and effectiveness. Addressing challenges such as technical infrastructure, user training, interoperability, and organisational support is crucial for enhancing EMR adoption and optimising patient care outcomes. This section synthesises existing literature on EMR adoption, outlining both its benefits and the persistent challenges that hinder widespread implementation.

Building on this body of research, the present study examines the nuanced experiences of healthcare professionals, exploring how EMR systems influence their daily workflows and decision-making processes. These findings provide a foundation for this study, which extends these themes by investigating the specific experiences of healthcare professionals within the Australian context.

3. Materials and Methods

After obtaining the necessary research ethics approvals (Griffith University Ethics Reference Number: ICT/09/14/HREC and Queensland Health Ethics Reference Number: HREC/13/QGC/113), we employed a phenomenological approach in this qualitative study to explore the experiences of a diverse cohort of healthcare professionals. The phenomenological approach was selected as it allows for an in-depth exploration of the lived experiences of healthcare professionals using EMRs [63]. A phenomenological approach was chosen as it allows for an in-depth exploration of healthcare professionals’ lived experiences with EMRs. Unlike other qualitative methods, phenomenology focuses on the subjective meanings individuals assign to their experiences, making it particularly suitable for understanding the real-world complexities of EMR adoption. This approach ensures that participants’ voices remain central, capturing both the benefits and challenges of EMR use in clinical practice. By identifying shared patterns and underlying concerns, phenomenology provides valuable insights that can inform user-centred EMR implementation strategies, improving system usability and integration into healthcare workflows.

This methodology facilitates a deeper understanding of personal and institutional barriers to EMR adoption, as well as the impact on workflow and patient care. By focusing on first-person accounts, phenomenological analysis ensures a rich contextual interpretation of EMR usability and adoption within hospital environments. Husserlian phenomenology, which emphasises the description of experiences as perceived by participants, guided our analytical approach. To minimise researcher bias, reflexivity was incorporated into the analysis process. Researchers maintained analytic memos throughout data collection to document initial impressions and potential biases. Additionally, member-checking was conducted by sharing preliminary findings with selected participants to ensure the accuracy of interpretations. The research team included experts in health informatics, qualitative research, and healthcare management. Reflexivity was maintained by documenting researcher perspectives and potential biases throughout data collection and analysis.

This study aimed to explore healthcare professionals’ experiences with EMRs in two large Australian hospitals: Gold Coast University Hospital (GCUH) and Royal Brisbane and Women’s Hospital (RBWH). An inductive approach was applied to develop a theory rather than test an existing one. To ensure the robustness of data collection, interviews continued until no new themes emerged during thematic analysis. This approach, consistent with prior studies [64,65], ensured data saturation was achieved. Although limited to two hospitals, these facilities are representative of large Australian healthcare institutions that have implemented EMR systems.

3.1. Data Collection

The primary data source comprised semi-structured and open-ended interviews conducted to explore healthcare professionals’ experiences with EMR usage. A total of 78 interviews were conducted across both hospitals, with 46 interviews at GCUH and 32 at RBWH. Each interview lasted approximately 45 to 60 min, depending on the participant’s availability and the depth of discussion. The final dataset for analysis comprised 78 interview transcripts, which were transcribed verbatim and analysed using NVivo software (Version 10) to ensure systematic thematic coding. All interviews were conducted by one research team member in a private setting within the hospital to ensure confidentiality, and transcripts were reviewed by participants to ensure accuracy. To ensure participant confidentiality and anonymity, all interviewees were assigned unique identification codes. However, specific professional roles (e.g., physician, registered nurse, or social worker) were not explicitly recorded in the dataset. Consequently, in the Results section, quotations from participants are attributed to the general descriptor “Healthcare Professional” rather than specific job titles. This approach maintains the integrity of anonymised qualitative data while addressing reviewer concerns regarding role identification.

The interview guide included open-ended questions focusing on EMR usability, perceived benefits and challenges, workflow impact, and collaboration among healthcare professionals. All interviews were recorded with participant consent and transcribed verbatim. To ensure clarity and completeness, transcripts were reviewed by the research team before analysis. The semi-structured and open-ended interviews enabled the researchers to uncover unanticipated yet potentially valuable insights while providing deeper explanations of factors influencing EMR adoption. The authors thoroughly reviewed all transcripts to ensure completeness and clarity before proceeding with data analysis. Participants were asked open-ended questions about their actual experiences with EMR and the challenges they encountered while using it. Appendix A contains examples of interview questions. To ensure a representative sample, this study applied the following inclusion and exclusion criteria:

Inclusion: Healthcare professionals actively were using EMRs for at least six months.

Exclusion: Temporary staff or professionals not involved in direct patient care.

Additionally, researchers collected demographic information through targeted demographic-related questions (see Figure 1).

3.2. Sample and Setting

Participants for this phase of the study were selected from EMR users at two large Australian hospitals. This study was conducted at Gold Coast University Hospital (GCUH) and Royal Brisbane and Women’s Hospital (RBWH), two major tertiary referral hospitals in Queensland, Australia.

• GCUH, located in a fast-growing metropolitan area, is a large urban public hospital serving the Gold Coast region. It offers comprehensive specialist services, including emergency care, oncology, cardiology, and neurology. GCUH is also a leader in digital health integration, with extensive use of EMRs.
• RBWH, in Brisbane, is one of Australia’s largest teaching hospitals, specialising in trauma care, maternal and neonatal care, transplants, and oncology. It has a well-established EMR system supporting interdepartmental collaboration and clinical training.

Both hospitals serve diverse patient populations, including metropolitan and regional communities, and are at the forefront of eHealth innovations, using EMRs to enhance patient care and streamline workflows.

A purposive sampling strategy was employed to ensure that diverse perspectives from different healthcare roles were included. Initial participants were identified through hospital EMR project managers and subsequent participants were recruited using a snowball sampling technique to access a broader range of EMR users, including physicians, nurses, administrators, and allied health professionals. Initially, the researchers identified potential participants through the EMR project managers at GCUH and RBWH, resulting in an initial pool of 40 healthcare professionals. Following this, snowball sampling was employed, allowing us to recruit an additional 38 participants, bringing the total to 78 interviews conducted. The interviews involved individuals from six different hospital roles (see Figure 2). Initially, the researchers contacted the principal project managers and EMR information managers at GCUH and RBWH, who agreed to provide an initial list of EMR users from various hospital departments. Additionally, the EMR information managers consented to randomly contact these potential participants to assess their interest in participating in the study.

Once the initial list of interviewees was identified, the researchers scheduled interviews at mutually agreed times and dates. Before the interview day, participants were provided with introductory information about the study along with an informed consent form for review. Participants were asked to read the information, sign the consent form, and return it to the researchers on the day of the interview. During the interviews, the researchers reiterated the study’s objectives and used a digital voice recorder to document participants’ responses.

At the conclusion of the interviews, participants were invited to nominate other potential EMR users, following the snowball sampling method. This non-probability sampling technique allows the sample group to expand progressively with each stage of data collection, akin to a snowball increasing in size as it rolls [66]. Initially, principal project managers provided a list of EMR users from various departments, forming the initial participant pool. The researchers then applied snowball sampling by asking these initial participants to recommend additional EMR users. This approach facilitated the collection of rich contextual narratives, offering valuable insights into the factors influencing user behaviour.

The initial goal was to interview at least 60 healthcare providers. However, after conducting 46 interviews at GCUH, data saturation appeared to be reached, as no new information emerged. Multiple rounds of transcript analysis confirmed the absence of additional themes. Based on our investigation into data saturation in qualitative research [64,65], we concluded that data saturation was achieved at GCUH. To gain additional insights, we selected another large hospital within the same state that utilised the same EMR infrastructure. Although the initial aim was to conduct 50 interviews at RBWH, data saturation appeared to be reached after 32 interviews, as no new information regarding EMR usage emerged.

Following qualitative research best practices, interviews continued until thematic saturation was achieved. According to Guest et al. (2006) [65], saturation often occurs within 20-30 interviews, though larger sample sizes may be required for diverse populations. In this study, saturation was observed after 46 interviews at GCUH and 32 interviews at RBWH, as no new themes emerged in later interviews. To confirm saturation, additional transcripts were reviewed and themes were validated through iterative consensus meetings. Time and resource constraints restricted the inclusion of additional hospitals with EMR systems in this study. Although this study provides rich qualitative insights, it is limited to two large hospitals in Queensland, Australia. Its findings may not be generalisable to smaller healthcare facilities or other geographic regions. Additionally, the reliance on self-reported experiences may introduce recall bias. Future studies should explore EMR experiences across different hospital settings using mixed-method approaches. Figure 3 illustrates the timeline of interviews conducted at GCUH and RBWH.

3.3. Data Analysis

Following the completion of the interviews, the researcher transcribed the responses into QSR NVivo V.10, a computerised qualitative data analysis software [67]. This software facilitates the collection, organisation, and analysis of qualitative and mixed-method research data. To enhance trustworthiness, member checking was conducted by returning selected transcripts and preliminary findings to participants for validation. Reflexivity was maintained through analytic memos documenting biases and emerging themes. Inter-rater reliability was ensured with two independent researchers coding a subset of transcripts. Data analysis followed an iterative process, with themes refined through multiple rounds of discussion to ensure consistency and credibility. The process of reducing, ordering, categorising, and collating data extracted from transcripts enabled the authors to gain an in-depth understanding of healthcare professionals’ experiences with EMRs. Data analysis followed Braun and Clarke’s (2006) [68] six-step thematic analysis approach:

• Familiarisation with the data
• Generating initial codes
• Searching for themes
• Reviewing themes
• Defining and naming themes
• Producing the final report

NVivo 10 software was used for data management and coding. Inter-rater reliability was assessed through independent coding by two researchers, achieving a Cohen’s kappa of 0.85, indicating strong agreement. Discrepancies in coding were resolved through consensus meetings among the research team. To ensure the reliability of thematic coding, interrater reliability was assessed through independent coding by two researchers. The agreement level was measured using Cohen’s kappa, yielding a value of 0.85, indicating strong agreement. Discrepancies in coding were resolved through consensus meetings among the research team, enhancing the credibility and dependability of the analysis.

Thematic analysis was employed to examine the qualitative data gathered from the interviews. As one of the most widely used approaches in qualitative research, this method focuses on identifying patterns and themes within the dataset [68,69]. Thematic analysis was chosen because it provides a flexible yet rigorous method for identifying and interpreting patterns within qualitative data. Unlike content analysis, which focuses on frequency counts, thematic analysis allows for a deeper exploration of participants’ perspectives on EMR usability and its broader implications for healthcare delivery. The analysis followed five key phases, as illustrated in Figure 4. Inter-rater reliability was assessed to validate thematic coding, with any discrepancies resolved through consensus meetings. This process enhanced the credibility and dependability of the thematic analysis.

• Familiarisation with the data: The researchers thoroughly read and re-read the data, identifying key variables influencing EMR adoption by analysing the use of nouns, verbs, adjectives, and adverbs in the interviewees’ responses.
• Coding: Concise labels (initial codes) were generated to highlight major features of the data based on the research questions. This phase involved multiple iterations, during which researchers refined the codes by adding, deleting, combining, or splitting them as necessary. Additionally, researchers provided interpretations to enhance the understanding of each code. By the end of this step, the data had been categorised into potential themes, preparing it for the next stage of analysis.
• Searching for themes: The researchers examined the coded data and interview transcripts to identify broad patterns of meaning and potential themes.
• Reviewing themes: Candidate themes were assessed against the interview transcripts to determine their relevance to the study’s objectives. Themes were finalised through iterative consensus meetings among researchers, ensuring alignment with the study’s goals. Inter-rater reliability was assessed to validate thematic coding, enhancing the credibility and dependability of the analysis. The final selection of themes was based on their recurrence in the data and their relevance to healthcare professionals’ experiences with EMRs. Consequently, some initial themes were split, merged, or discarded.
• Defining and naming themes: In this phase, researchers conducted a detailed analysis of each theme, providing a comprehensive description of its significance in addressing the study’s research objectives.

This study was conducted and reported following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines [70]. The COREQ checklist was used to ensure transparency and completeness in reporting, covering aspects such as study design, data collection, researcher reflexivity, participant recruitment, and thematic analysis.

4. Results

This section presents the key findings from 78 interviews conducted across two major Australian hospitals. The results are structured around four primary themes: (1) healthcare professionals’ engagement with EMR systems, (2) job performance, (3) collaboration among healthcare professionals, and (4) quality of care and patient satisfaction. These themes highlight both positive and negative experiences with EMR usage, revealing key adoption challenges and benefits.

4.1. Healthcare Providers’ Experience Regarding EMR Use in Medical Decision-Making

A total of 78 healthcare professionals, comprising 48 females and 30 males, were interviewed from two large hospitals in Australia. The interviews were conducted by one of the researchers involved in the study. Analysis of the data revealed four overarching themes: (1) healthcare professionals’ engagement with EMR systems, (2) job performance in relation to task completion, (3) collaboration among healthcare professionals, and (4) quality of care and patient satisfaction.

Table 1. Frequency of themes identified in the interview responses.

Themes	Hospital Administrators	Physicians	Surgeons	Registered Nurses	Social Workers	Pharmacists	Total
Healthcare professionals’ engagement with EMR system	23 a	29	18	47	43	12	172 (15%)
Job performance	38	86	27	52	15	31	249 (22%)
Collaboration among various healthcare professionals	79	49	30	128	32	6	324 (29%)
Quality of care and patient satisfaction	61	103	41	117	35	23	380 (34%)
Total	201 (18%)	267 (24%)	116 (10%)	344 (30%)	125 (11%)	72 (7%)	1125

(a) Number of comments based on participants’ roles and proposed themes.

presents the frequency of themes based on participants’ roles within the hospitals. As shown in Table 1, registered nurses contributed the highest number of comments on collaboration (theme 3), highlighting their pivotal role in interdepartmental communication and patient care coordination. Likewise, Figure 2 illustrates the diverse professional roles of participants, underscoring the multidisciplinary nature of EMR adoption.

As summarised in Table 1, the analysis highlights differences in EMR experiences across various healthcare roles. While registered nurses reported the highest engagement with EMR systems in their daily tasks, hospital administrators primarily focused on the impact of EMRs on interdepartmental collaboration. These variations suggest that role-specific training and system optimisation may be necessary to enhance usability and adoption across different professional groups.

For instance, registered nurses contributed more comments on the first theme, discussing their interaction with EMRs more frequently than other healthcare groups. Physicians, on the other hand, focused primarily on the impact of EMRs on job performance. Additionally, registered nurses placed greater emphasis on the role of EMRs in facilitating collaboration among healthcare professionals and enhancing patient care, aligning with the third and fourth themes. Overall, different professional groups highlighted distinct aspects of EMR adoption. Hospital administrators primarily discussed the benefits of EMRs in fostering collaboration among healthcare providers (theme 3), while physicians concentrated on the impact of EMRs on the overall quality of care (theme 4). Surgeons also focused on quality of care and patient satisfaction (theme 4). Registered nurses were particularly concerned with the role of EMRs in improving collaboration among healthcare professionals (theme 3). Social workers primarily discussed their interaction with EMRs (theme 1), while pharmacists contributed more insights on the impact of EMRs on job performance (theme 2).

4.1.1. Healthcare Professionals’ Engagement with EMR System

According to the transcripts, participants expressed two contrasting perspectives regarding their interaction and engagement with the EMR system for storing and retrieving patient data. A majority (59%) reported positive experiences with using computers to enhance the quality of care in hospitals. They provided various forms of positive feedback, highlighting the benefits of EMRs in their daily tasks. Key advantages mentioned included the ease of creating medication charts, the elimination of issues related to illegible handwriting, faster information retrieval, improved accessibility to patient data, and overall time savings. The findings indicate that prior exposure to EMR systems significantly influences users’ interactions. Participants with previous EMR experience adapted more easily, reporting fewer usability concerns. Conversely, those without prior exposure faced challenges in system navigation, which suggests a need for targeted onboarding and technical support.

‘By using EMR, I do not have to write on a piece of paper and I can type into well-formatted electronic forms. It can save our time to input patient data and decrease illegible hand writing.’

‘I can easily sort notes by date or type or profession. It can save my time and documentation so that I can focus on my career.’

(Healthcare Professional)

In addition, 21% of participants reported that they found the EMR system easy to use and expressed a preference for incorporating it into their tasks to enhance the quality of care.

‘I found it easier to flick through a paper chart and you could easily see their journey through outpatients and the number of admissions; I could quickly gauge what they were for and their duration.’

(Healthcare Professional)

Registered nurses, who constituted the majority of respondents, highlighted the collaborative benefits of EMRs, whereas physicians primarily emphasised the system’s impact on workflow efficiency. These differences suggest that role-specific experiences influence perceptions of EMR usability. Among the participants who reported positive interactions with EMRs, 17% had prior experience with EMRs in previous employment at different hospitals.

Professional roles and prior exposure to EMRs significantly shaped participants’ perceptions, with those familiar with the system demonstrating greater ease of use and a more favourable outlook. This variation underscores the need for role-specific training and tailored support systems to enhance adoption and usability. Participants with prior experience were already familiar with the benefits and functionalities of EMRs, allowing them to interact with the system more effectively.

‘I worked with EMR when I was in Robina Hospital. I knew the potential benefits of EMR and also knew how to scan medical images and import them to the computer system. …, I did not have specific problems in working with the new EMR system and I think that it is really useful in my work.’

(Healthcare Professional)

Furthermore, 23% of participants reported having basic computer knowledge prior to using EMRs. They emphasised that foundational computer skills, including proficiency in using a mouse and keyboard, were essential for effectively navigating and utilising the EMR system.

‘… Users should have computer knowledge to navigate EMR and use different EMR functions. I used different multi-function programs before using EMR in the hospital and the helped me to control EMR in my tasks.’

(Healthcare Professional)

Nevertheless, 27% of interviewees reported negative experiences with EMR usage. These participants identified several factors contributing to their dissatisfaction, including software and hardware issues, loss of information due to the complexity of certain EMR sections, power outages, and difficulties with scanning documents.

‘The EMR interface is complex to use. There are so many buttons to view the history of patients in the system. There is no complete reporting system to show the whole journey.’

(Healthcare Professional)

‘Occasionally the whole program will shut down, losing anything you were doing at the time … The system cannot spell check and some staff do not read the notes after typing.’

(Healthcare Professional)

Additionally, some participants voiced concerns about the security of the EMR system as a platform for storing patients’ health-related information. They were particularly apprehensive about potential risks such as system crashes, computer viruses, and hacker attacks, which could compromise patient data.

‘I am worried about computer problems and viruses attacking the system. They cause loss of access to medical records in the hospital.’

(Healthcare Professional)

‘I understand EMR can improve quality patient care, but let’s talk about security breaches in the system. I have a problem with my desktop computer at home and it can also happen in my office.’

(Healthcare Professional)

According to the transcripts, 13% of participants reported having limited experience with computer-based systems and a lack of essential computer skills. This deficiency negatively impacted their overall experience with EMRs. Healthcare providers with inadequate computer skills—such as proficiency in keyboard and mouse use, internet navigation, and email—required more time to operate the EMR system, which, in turn, diverted their attention from patient care.

‘It takes time to use the keyboard for typing my patients’ data into EMR. It is difficult to find the keys and navigate the system.’

(Healthcare Professional)

4.1.2. Job Performance

This theme focuses on workflow challenges within hospitals and the impact of EMRs on healthcare professionals’ performance. It is based on healthcare providers’ interactions with information and their patients, encompassing the time required to capture, retrieve, and process data. EMRs can enhance efficiency and facilitate task completion. Some participants (28%) reported improvements in their work performance with the support of EMRs. They highlighted various benefits, including real-time documentation, improved accuracy of patient data, and enhanced decision-making capabilities. For instance, 18% of participants stated that EMRs aid clinical decision-making by providing a secure and easily accessible framework for healthcare providers and management teams within healthcare organisations.

‘EMR provides a clear record of a patients’ journey in the hospital so we can make better decisions during patients’ treatment.’

(Healthcare Professional)

In contrast, 20% of participants expressed concerns about using EMRs in their daily tasks, citing various factors that negatively impacted their performance. Key challenges included the time required for documentation, additional steps needed to complete tasks, and the inconvenience of multiple logins. Additionally, participants reported experiencing hardware and software issues related to data storage, retrieval, and information sharing across departments, which further hindered job performance. Some noted that EMRs reduced their efficiency due to the extra steps required to complete tasks. Specific concerns included multiple logins and the use of rigid, standardised forms, which they felt compromised the richness of language within the system.

‘We lose documentation sometimes if it has not been saved. It’s not easy to cut and paste from each program. You need to paste into a word document from meta-vision (specific program in the hospital) and then into EMR.’

(Healthcare Professional)

‘We face multiple login pages in different parts of EMR and this wastes our time. It should have one login page only.’

(Healthcare Professional)

Furthermore, 11% of participants reported that using EMRs required additional effort and time for documentation. They felt that the system was not user-friendly and demanded extra time and effort to input patient information.

‘Data entry takes a long time because we have to convert all charts and images, and I think that this should be improved to save nurses’ time.’

(Healthcare Professional)

While some healthcare professionals perceived EMRs as improving job performance through real-time documentation and workflow efficiency, others expressed concerns regarding excessive documentation time and multiple logins. These findings suggest that usability improvements, such as system integration and streamlining data entry processes, could enhance user satisfaction and efficiency.

4.1.3. Collaboration Among Various Healthcare Professionals

Computer-based technologies, such as EMRs, have the potential to transform hospital work environments [71]. Collaboration and teamwork among healthcare providers—including doctors, nurses, surgeons, health department managers, and patient support assistants—are essential for making informed healthcare decisions. The findings indicate that EMRs can facilitate collaboration and teamwork among healthcare professionals, ultimately improving the quality of care. By ensuring that stored information is accessible to the right person at the right time, EMRs enhance coordination within hospitals. Additionally, 29% of participants reported that EMRs improved unit-specific collaboration among staff. For instance, in emergency departments, where doctors and nurses work closely together, EMRs assist in retrieving the most relevant and up-to-date information to support clinical decision-making.

‘… EMR is useful software that provides a big picture of patients’ care. Everyone in our department can trace patients’ information and help their colleagues for better treatment.’

(Healthcare Professional)

Furthermore, some participants expressed satisfaction with using EMRs, as they facilitated collaboration across multiple hospital departments rather than being limited to a single care unit. EMRs enable the seamless sharing of patient information across various disciplines and care departments, enhancing interdisciplinary coordination. Additionally, 16% of participants reported that EMRs improved cross-departmental collaboration and communication among healthcare providers, ultimately contributing to better quality of care. The results illustrate the dual impact of EMRs on collaboration. While many participants highlighted improved access to shared medical data as a facilitator of teamwork, others expressed concerns regarding system-related time constraints and reduced interpersonal communication. These findings suggest that optimising system design to improve interoperability while maintaining clinician autonomy is essential to fostering effective interdisciplinary collaboration. Future research should explore strategies to enhance system integration while ensuring that EMRs complement rather than replace human interactions in patient care.

‘I can read my patient’s medical history in EMR that completed by other doctors. Last week, I saw allergies reactions in one record of my patient that was written by doctor in emergency department, I decided to adjust his diet according to this information from other doctors.’

In addition, 9% of participants noted that EMRs enabled them to track patient information across different hospital departments more efficiently.

‘…, accessing and managing medical data has become easier. It is easy to find suitable information and track a patient’s journey in the hospital.’

(Healthcare Professional)

Some participants (14%) reported that EMR usage added time pressure to their workload, making them too busy or lacking the necessary skills to assist colleagues and other staff. This issue negatively impacted collaboration among healthcare professionals. Additionally, some doctors expressed the need for more time to enter patient information, search for data, and retrieve the correct type of information while using the EMR system.

‘My colleague asked me about EMR functions several times. I do not have enough time and insufficient skill in EMR, and I am worried that if I help him, he will get in trouble because of my mistakes.’

(Healthcare Professional)

Moreover, 9% of participants expressed concerns about losing their autonomy as a negative consequence of EMR implementation on healthcare professionals’ collaboration. They believed that EMRs reduced their control over patient treatment decisions. Specifically, they noted that EMRs enabled data sharing across all hospital departments, allowing other healthcare providers to modify previously recorded information. These findings highlight the dual role of EMRs in fostering and hindering collaboration. While the system enables real-time access to shared patient data, interoperability limitations and time constraints may reduce healthcare professionals’ ability to engage in meaningful interdisciplinary collaboration. Addressing these challenges through system enhancements and workflow adjustments could improve teamwork in hospital settings.

‘I think that by using EMR we lose control over medical information, because data is shared with others and they can evaluate and modify that information.’

(Healthcare Professional)

Lastly, interoperability issues were a significant concern. Seventeen per cent of participants reported that the current EMR system in their hospital could not integrate with other healthcare record systems, such as those used by private pathology or diagnostic imaging providers, private hospitals, or medical billing agents. As a result, they found that critical patient information was often unavailable, difficult to interpret, or incompatible with other caregivers’ record systems, posing challenges to seamless patient care.

‘… when I have new patients, It is difficult to gather their previous test results, prescriptions, or other medical history. In an emergency, I have to contact the previous doctors directly to monitor my patient’s health summary.’

(Healthcare Professional)

4.1.4. Quality of Care and Patient Satisfaction

More than half of the healthcare professionals (56%) perceived EMRs as having a positive impact on patient care by enhancing documentation, reducing errors, and improving patient satisfaction. They believed that patients felt safer when care providers used EMRs due to a lower risk of errors, clearer documentation—such as prescriptions—the elimination of duplicate records, and the increased security of the system.

‘I have a quicker response from other physicians’ staff and patients by applying EMR in my workplace. I can read a patient’s medical history more quickly than with a paper system.’

(Healthcare Professional)

‘EMR provides comprehensive and easy access to medical information so that we can make better decisions and use better judgment in our tasks, and we can focus on patients’ needs in the hospital.’

(Healthcare Professional)

On the other hand, 24% of participants expressed concerns that EMRs could negatively impact the quality of care and patient satisfaction. Some healthcare professionals were particularly concerned about slower patient service, citing various software and hardware issues that affected the storage and retrieval of information. They perceived that these technical challenges could have a detrimental effect on overall patient care.

‘Occasionally computers are down, or I don’t have computer access for some reason during patient visits.’

(Healthcare Professional)

‘If the IT system goes down and notes cannot be accessed or written, I have to rewrite them and this is a waste of my time. It can be disaster in emergency situation in the hospital.’

(Healthcare Professional)

Furthermore, 19% of participants noted that, in some situations, patients felt that healthcare providers spent excessive time interacting with the computer rather than being fully present—both mentally and physically—at their bedside.

‘I had some patients who complained that I was sitting at the computer and do not listen to their speech…’

(Healthcare Professional)

‘It takes time to enter patients’ information into the system. Sometimes patients are uncomfortable about this situation and they like to have more active time with them.’

(Healthcare Professional)

Finally, 5% of healthcare providers reported encountering patients who had concerns about security and privacy. These patients had negative experiences with computer-based systems, including issues such as computer viruses, system crashes, hardware failures, slow start-up times, missing files, and unexpected error messages. As a result, they were reluctant to share all their private health-related information with their doctors, as it would be stored in the hospital’s EMR system. Consequently, healthcare providers lacked accurate and comprehensive patient information, which negatively impacted the quality of care and overall patient satisfaction.

‘… My experienced shared security breaches in the computer system… He had some problems with computer freezing during using computer at home. He asked me that if doctors face these problems, is there any backup plan to retrieve information. From that date, I have tried to find more information related to security features of EMR.’

(Healthcare Professional)

Table 2. Summary of healthcare providers’ experience regarding EMR.

Themes	Positive Feedbacks	Negative Feedbacks
Healthcare professionals’ engagement with EMR system ‘n = 67’	(n = 46 a, 59% b of participants) ▪ Making an easy approach to creating medication charting ▪ Avoiding illegible handwriting ▪ Faster searching for information ▪ Providing easy access to patients’ data ▪ Saving time ▪ Easy to use	(n = 21, 27% of participants) ▪ Facing software/hardware problems ▪ Losing information because of the complexity of some EMR sections ▪ Security/privacy concerns ▪ Power loss ▪ Problem with scanning
Job performance ‘n = 38’	(n = 22, 28% of participants) ▪ Providing real-time documentation ▪ Protecting the accuracy of patients’ data ▪ Providing a better view of comprehensive workflow reporting	(n = 16, 20% of participants) ▪ Time for documentation ▪ Some extra steps for task accomplishment ▪ Multiple logins
Collaboration among various healthcare professionals ‘n = 50’	(n = 28, 36% of participants) ▪ Improving unit-specific collaboration among staff ▪ Providing better collaboration across different departments ▪ Better tracking of information in different departments in the hospitals	(n = 22, 28% of participants) ▪ Additional time pressure ▪ Concerning about losing autonomy ▪ The interoperability issue
Quality of care and patient satisfaction ‘n = 63’	(n = 44, 56% of participants) ▪ Improving patients’ data documentation ▪ Reducing errors ▪ Improving the overall patient satisfaction	(n = 19, 24% of participants) ▪ Slower patient service because of software/hardware problems ▪ Participants noted that patients sometimes perceived healthcare providers as preoccupied with computers, impacting perceived attentiveness during care ▪ Patients’ concerns related to privacy and security issues related to their information in EMRs

(a) Number of participants. (b) Percentage of participants (out of 78).

presents a summary of participants’ experiences with EMRs, categorised into positive and negative feedback. Overall, the majority of participants stated that EMRs are a valuable tool for enhancing the quality of care, improving patient satisfaction, and optimising job performance in hospitals. The percentages indicate the proportion of the total interviewees (N = 78) who discussed each theme. Since participants could mention multiple themes, the percentages do not total 100%.

Overall, the results suggest that EMRs can enhance patient safety by reducing documentation errors and providing timely access to medical records. However, concerns related to system downtime, provider workload, and patient perceptions of reduced face-to-face interaction indicate that further refinements are needed to balance efficiency with patient-centred care. Future research should explore how usability enhancements and workflow optimisations could improve both provider satisfaction and patient outcomes.

These findings provide a comprehensive overview of the experiences of healthcare professionals using EMR systems in Australian hospitals. The following discussion will explore these results in relation to existing literature, identifying potential solutions to enhance EMR usability, interoperability, and overall healthcare efficiency.

5. Discussion

When implementing new technologies, organisations often face complex decision-making scenarios that require systematic evaluation approaches. Research has shown that effective decision-making can significantly improve technology selection and adoption outcomes [72,73,74,75]. As discussed earlier, EMRs play a crucial role in reducing errors, streamlining workflows, and enhancing decision-making capabilities. These findings align with previous studies that emphasise the transformative potential of EMRs in healthcare delivery [20,32,76]. This study provides an in-depth understanding of healthcare providers’ experience regarding EMR use. Our results indicate that the majority of participants had good interaction with EMRs in their daily tasks in the hospitals. Prior research has demonstrated that EMRs facilitate healthcare providers’ workflow by improving documentation, streamlining processes, and enhancing efficiency in hospitals [20,76]. Studies suggest that EMRs can provide a better documentation process, enhance workflow visibility, simplify medication charting, and save time, ultimately supporting clinical decision-making [18,23]. Every healthcare provider acknowledged the advantages of EMR systems compared to traditional paper-based medical records, a finding consistent with previous literature showing that EMRs reduce medical errors and improve record-keeping [21,77]. Several participants shared positive experiences with EMR usage, emphasising its potential to enhance the quality of care. Empirical evidence suggests that EMRs facilitate a unified platform, enabling healthcare professionals to collaborate more effectively and make well-informed decisions [12,71].

As highlighted in the introduction, EMRs have demonstrated potential in reducing errors and improving workflows. This study builds on these findings by examining how these benefits are realised in Australian hospitals while also identifying barriers specific to this context. These advantages align with existing literature on the role of computer-based systems in enhancing patient care [76,77]. Moreover, the results indicate that participants with prior experience using EMRs and stronger computer skills reported more positive interactions with the system. According to the literature, basic computer competencies—such as proficiency in keyboard and mouse use, internet navigation, and email—are essential for effectively utilising computer-based systems in hospitals [39,78].

Conversely, some participants reported negative experiences with EMR usage. Those who expressed dissatisfaction often cited system complexity and inadequate training as key barriers. Addressing these challenges through targeted interventions, such as user-centred design and role-specific training, could significantly enhance EMR adoption and usability. Our findings indicate that EMR usability remains a significant determinant of adoption and satisfaction. Participants with prior experience adapted more smoothly, while those without such exposure encountered difficulties navigating system functionalities.

Previous research has consistently shown that prior exposure to EMR systems significantly influences adoption rates and usability perceptions among healthcare professionals. Studies by Boonstra and Broekhuis (2010) and Ludwick and Doucette (2009) indicate that clinicians with previous EMR experience report fewer usability challenges and adapt more quickly compared to those with minimal exposure [39,50]. Our findings align with this trend, as participants with prior EMR knowledge found the system easier to navigate, whereas those with limited experience reported steeper learning curves and higher frustration levels. However, our study also highlights key differences. Unlike previous research that primarily emphasises the importance of structured EMR training, our participants expressed a need for role-specific training and ongoing support rather than one-time onboarding sessions. Additionally, interoperability challenges were more pronounced in our study, with multiple participants reporting difficulties in retrieving external medical records, a barrier that prior studies have not extensively examined in the Australian healthcare context [46]. While past studies have largely quantified EMR adoption barriers, our qualitative approach provides in-depth narratives that reveal how EMRs influence clinical workflows, collaboration, and decision-making in real-world settings. This richer contextual understanding underscores the nuanced challenges faced by healthcare professionals, such as increased documentation time, loss of autonomy, and concerns over system reliability, which are often overlooked in quantitative analyses. These findings reinforce the need for targeted interventions to enhance EMR usability, including improved system design, structured role-based training programs, and policy measures that support seamless interoperability.

These findings reinforce the need for structured training programs and user-friendly interface designs to mitigate barriers to EMR use. Prior studies have also emphasised that poorly designed systems can contribute to inefficiencies and user dissatisfaction, highlighting the importance of continuous usability evaluations to enhance adoption rates. We found that these healthcare providers lacked sufficient computer skills and perceived EMR usage as time-consuming. Our findings suggest that inadequate computer competencies represent a major barrier to EMR adoption. According to our results, individuals without basic computer skills struggle to interact effectively with computer-based technologies across various organisational sectors. These findings are consistent with previous studies, which have similarly identified a lack of information technology skills as a significant barrier to EMR adoption [76,79,80].

Furthermore, participants with limited computer skills expressed concerns about the security and privacy of the EMR system. They were particularly worried about system crashes, computer viruses, and the potential for hacker attacks compromising patient information. According to the literature [76,81,82], some healthcare professionals believe that implementing computerised medical record systems in hospitals may negatively impact patient privacy. Many healthcare providers were uncertain about whether EMRs offer a secure platform for storing patient information and were concerned about the risk of unauthorised access. Additionally, physicians expressed apprehension that the disclosure of patient data could lead to legal complications [83,84]. These findings highlight the interconnected nature of EMR adoption challenges. Addressing issues such as training, usability, and interoperability in parallel is essential for maximising the potential benefits of EMRs in healthcare delivery.

In addition, some participants perceived that EMRs had a positive impact on job performance. Consistent with previous research [85], our findings indicate that healthcare professionals provided positive feedback on EMR usage, citing benefits such as easy access to information, improved timeliness and accuracy of data, enhanced workflow processes across hospital departments, better identification of staff needs, and improved decision-making.

This finding aligns with existing EMR literature [86,87], which highlights that EMRs can enhance task performance by reducing written errors, supporting clinical decision-making, and providing improved workflow reporting for healthcare providers. Moreover, we found that EMRs can strengthen clinical decision-making by offering a secure and easily accessible platform for healthcare providers and administrative staff within healthcare organisations.

Conversely, some participants reported that EMRs negatively impacted their job performance. They expressed concerns about multiple logins, additional steps required to complete tasks, and the time-consuming nature of documentation. According to the literature [29], these issues may stem from challenges related to data storage, retrieval, and sharing procedures, as well as power outages, data security concerns, portable device limitations, system downtime, network connectivity, and software-hardware compatibility. For successful EMR adoption, users must have confidence in the system’s backend infrastructure and overall reliability [88].

Furthermore, this study highlighted the role of EMRs in improving communication among healthcare professionals, both within specific units and across departments. Some participants believed that EMRs enhanced collaboration among various healthcare professionals, including doctors, surgeons, nurses, patient support assistants, and care department managers. This improved teamwork positively influenced organisational culture among staff. Additionally, a supportive attitude from colleagues was found to facilitate EMR adoption. These findings align with existing literature, which suggests that EMRs enhance communication within hospitals by enabling doctors to share patient records with other healthcare providers, thereby supporting the treatment process [85].

On the other hand, some participants expressed concerns about the negative impact of EMRs on collaboration among healthcare professionals. They reported that the additional time required for documentation—such as data entry and document scanning—made them busier with administrative tasks, reducing their availability for direct collaboration with colleagues.

Moreover, some interviewees indicated that EMRs could negatively affect their autonomy. They believed that EMR systems diminished their control over patient care, a concern that aligns with existing literature suggesting that some physicians perceive EMRs as a threat to their professional autonomy [80,89]. These participants also expressed concerns about patient data disclosure, fearing that EMRs compromised their control over sensitive information [39].

Finally, some participants reported that EMR systems lacked interoperability with external healthcare systems. They noted difficulties in accessing patients’ medical histories stored in other healthcare organisations, leading to gaps in patient information. The issue of interoperability remains one of the most critical challenges in EMR implementation. According to the literature [90], EMRs should integrate seamlessly with other healthcare organisations to provide a patient-centric system that enhances care delivery.

In addition, some participants perceived that EMRs could enhance the quality of care and patient satisfaction by minimising human errors, facilitating easier access to patient information, reducing duplication of effort and documentation, optimising staff resources allocated to patient management, and lowering technology-related transaction costs in the healthcare sector. While some participants perceived EMRs as facilitating real-time documentation and decision-making, others reported that excessive documentation requirements and fragmented workflows negatively impacted efficiency. These findings suggest that system refinements, such as automated data entry and streamlined login procedures, could significantly enhance healthcare professionals’ productivity. Aligning these results with prior research, it is evident that the success of EMR adoption depends on balancing efficiency with usability, ensuring that digital solutions complement rather than hinder clinical workflows. They indicated that EMRs could enhance documentation in hospitals by providing a user-friendly digital format and reducing medical errors during data entry. The positive impact of EMRs on patient safety aligns with existing literature, which highlights the role of these computer-based systems in improving patient satisfaction. Stream [91] conducted a survey evaluating user adoption of health record systems and reported that such systems could enhance both the quality of care and patient satisfaction. Although EMRs optimise documentation and minimise human errors, they may also introduce workarounds that negatively affect healthcare safety and quality. According to the literature [39,77,80,92], several EMR-related concerns could compromise patient safety, including increased time per patient, prolonged data entry processes, disruptions to the doctor-patient relationship, temporary productivity loss during EMR adoption, security and privacy risks, and hardware/software issues.

Addressing interoperability challenges requires the adoption of standardised data formats and improvements in system compatibility. Emerging frameworks, such as Fast Healthcare Interoperability Resources (FHIR), provide potential solutions for enabling seamless data exchange across healthcare systems [93,94]. Hospital management should prioritise structured training programs tailored to the varying levels of computer literacy among healthcare professionals. Additionally, simplifying EMR interfaces and reducing redundant documentation processes—such as minimising multiple logins—are critical steps toward improving system usability and efficiency. This study contributes to the existing body of knowledge by offering a nuanced perspective on EMR usability and adoption challenges within the Australian healthcare system. Unlike previous research that predominantly focuses on technical functionality, our findings highlight the practical experiences of healthcare professionals, providing actionable insights for policymakers and hospital administrators. Addressing usability concerns, refining training programs, and improving system interoperability should be prioritised to enhance EMR effectiveness and user satisfaction. By acknowledging these findings, decision-makers can implement targeted interventions that align digital health initiatives with clinical realities.

While the findings of this study provide valuable insights into EMR adoption and usability challenges, it is important to acknowledge the evolution of digital health technologies since the data was collected. Over the past decade, enhancements in EMR functionality, including automation, voice recognition, and improved data-sharing frameworks, may have addressed some of the barriers identified in this study. Additionally, the increasing integration of EMRs with telehealth services and real-time clinical decision support tools could have altered healthcare professionals’ perceptions of system usability and effectiveness. Given these rapid advancements, future studies should revisit these themes with updated datasets to assess how technological progress has reshaped EMR adoption experiences.

6. Limitations

This study has several limitations. First, it included only a small number of hospitals. The time and resource-intensive nature of qualitative research presents challenges for large-scale studies and limits the generalisability of findings to settings with diverse organisational characteristics or market constraints. Nonetheless, the in-depth insights gained from this study provide a foundation for future research, which can further validate these findings using larger samples and survey-based methodologies.

This study’s findings are also limited by its focus on two large hospitals in Australia. While these settings provided rich contextual data, future studies should explore a broader range of healthcare environments to enhance generalisability. Additionally, the use of snowball sampling may have introduced selection bias, as participants were likely to recommend colleagues with similar experiences or perspectives. The qualitative nature of this study also limits its applicability to broader healthcare settings. Future research should aim to include a more diverse participant pool and incorporate quantitative methodologies to validate and extend these findings.

Although the sample was carefully selected, it may not fully represent the entire EMR user population. However, the inclusion of both positive and negative perspectives in participant responses suggests that a diverse range of experiences was captured, thereby strengthening the reliability of the findings.

This study identified four key themes from the qualitative data. The presence of researchers during data collection—an inherent aspect of qualitative research—may have influenced participants’ responses. Future research should employ quantitative methods to assess the significance of factors identified from users’ experiences. Expanding the study to include diverse healthcare settings, such as rural hospitals and private practices, would provide further insights into variations in EMR adoption across different organisational contexts.

A key limitation of this study is the age of the dataset, as the interviews were conducted approximately ten years ago. Since then, there have been significant advancements in electronic medical record (EMR) technologies, including improvements in user interface design, interoperability, and artificial intelligence-driven decision support systems. Additionally, the adoption of cloud-based EMR solutions and mobile health technologies has transformed how healthcare professionals interact with EMRs. These developments could influence healthcare professionals’ perceptions and experiences differently if the study were conducted today. Future research should re-examine these themes in light of recent technological advancements to assess whether the same usability challenges and workflow barriers persist.

7. Implications

The earlier sub-section proposed that healthcare professionals’ experience regarding EMR can be discussed in four main themes, including healthcare professionals’ engagement with EMR systems, job performance collaboration among various healthcare professionals, and quality of care and patient satisfaction. To propose a model to support decision-making, we adopted the satisfied view of the health IT evaluation model to clarify the relationships among the level of experience among healthcare professionals [95]. In fact, the main objective of EMR implementation is to enhance decision-making and care quality in health sectors [96]. To achieve this goal in care, we divided healthcare professionals’ experience into three clusters (see Figure 5).

Figure 5 illustrates the interactions between different healthcare professionals and the EMR system. Each box represents an individual user along with their respective tasks and system interactions. The arrows indicate the relationships between different users and systems, highlighting how information flows within the hospital environment. These relationships reflect the collaboration required among various healthcare professionals, including physicians, nurses, administrators, and IT support staff, to ensure efficient EMR usage. The figure also demonstrates how different roles experience unique challenges and benefits in EMR adoption, emphasising the need for role-specific training and system optimisation to enhance usability and collaboration.

The first relationship (R1) shows healthcare professionals’ experience regarding interaction with EMR, system workflow, and job/task performance. In the interaction between healthcare providers and EMR, we identified some factors that negatively impact participants’ experience, such as software/hardware problems, lack of computer skills, system complexity, and documentation time. Policymakers and health management teams should schedule standard training and workshops for individuals with different computer or EMR knowledge levels. Training activities have positive consequences on the performance of individuals. Moreover, more interactive technical support is needed to provide continuous and repetitive evaluation of healthcare providers’ interaction with HIT applications in hospitals to identify operational failures that hinder task completion [97]. Technical training goes beyond asking general questions; it requires in-depth knowledge and specialised instruction, unlike customer service. Nevertheless, various factors impact user adoption of EMR, and there is a lack of research on personalised support to fulfil various characteristics of healthcare professionals to assess their needs toward using EMR [39].

The second relationship (R2) shows healthcare professionals’ collaboration in different departments of the hospital (unit-specific and across-departmental collaboration). We identified some contexts that had a negative impact of EMR on healthcare professionals’ collaborations with their colleagues in the hospital (organisational level), such as EMR causing additional time pressure on users and perception of losing individual autonomy. Top-level managers in hospitals can play an important role in motivating healthcare professionals to accept HIT applications in the health sector. Research evaluating the influence of top-level managers’ characteristics on motivating employees to adopt EMR remains limited. Leaders who are more innovative, well-informed, and knowledgeable about computer-based systems are more likely to inspire users to adopt and integrate technologies into their tasks [98]. Furthermore, top-level management support is needed to change policies regarding the adaptation of medication administration and documentation requirements with EMR systems. Healthcare professionals should not have any concerns about their autonomy.

The third relationship (R3) shows collaboration and communication across other healthcare organisations. Data should be shared across hospitals, pharmacies, labs, clinicians and patients, regardless of which vendor is being used. Interoperability allows healthcare providers to access longitudinal individual records, which are essential for long-term improvement in quality of care and patient satisfaction, and provides an integrated patient-centric system to enhance quality of care and patient safety. In order to address interoperability challenges, adopting standardised frameworks such as Fast Healthcare Interoperability Resources (FHIRs) and integrating health information exchanges (HIEs) can facilitate seamless data exchange across healthcare organisations. For example, the NHS in England has integrated FHIR-based solutions to facilitate data sharing across its healthcare network, significantly improving care coordination and patient outcomes [62]. Similar efforts in Australian healthcare could address current interoperability challenges.

Emerging frameworks, such as Fast Healthcare Interoperability Resources (FHIRs), have been successfully adopted by healthcare networks, including [specific examples, e.g., NHS or US healthcare systems], to facilitate seamless cross-organisational data sharing and improve patient outcomes [93,94]. HIT applications such as EMR should communicate, exchange, and use data with the same fundamental standard.

8. Conclusions

This study explored the experiences of healthcare professionals with EMR systems, identifying four key themes: usability and interaction with technology, impact on job performance, collaboration across healthcare teams, and patient care outcomes. Our findings highlight both the benefits and challenges of EMR adoption, revealing that while EMRs enhance information accessibility and workflow efficiency, they also introduce usability and interoperability challenges that impact adoption rates. This study underscores the need for user-centred system improvements, targeted training programs, and streamlined data entry processes to reduce usability barriers. Additionally, our findings reveal the dual role of EMRs in collaboration, where improved access to shared data enhances teamwork, but workflow constraints sometimes reduce interpersonal communication. From a policy perspective, these insights suggest that EMR implementation strategies should prioritise usability refinements, seamless interoperability, and clinician support to maximise adoption and effectiveness. By addressing these concerns, hospital administrators and policymakers can optimise EMR usability and drive meaningful digital transformation in healthcare. Future research should explore the long-term impact of EMR usability enhancements on clinical efficiency and patient outcomes, ensuring that technology aligns with the evolving needs of healthcare professionals. This study adheres to the COREQ guidelines to ensure the transparency, credibility, and rigour of the qualitative research process. By following these established reporting criteria, we enhance the reproducibility and reliability of our findings for both researchers and practitioners in the field of healthcare informatics.