Implementation and use of electronic patient records in the Brazilian Air Force: a cross-sectional study<sup>1</sup>

Boas, Patrícia Mesquita Vilas; Vieira, Luiza Jane Eyre de Souza; Silva Júnior, Geraldo Bezerra da; Lira, Geison Vasconcelos; Oliveira, Juliana Gomes Ramalho de

doi:10.1590/1806-9282.20231136

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Original Article • Rev. Assoc. Med. Bras. 70 (4) • 2024 • https://doi.org/10.1590/1806-9282.20231136 copy

Implementation and use of electronic patient records in the Brazilian Air Force: a cross-sectional study¹

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

The objective was to analyze the implementation and use of the electronic patient record in the health services of the Brazilian Air Force.

METHODS:

This is a cross-sectional study carried out with 234 physicians, between March and May 2021. The data collection instrument was sent by email. The electronic patient record was implemented in the Air Force approximately 3 years ago (64.5%), and about 81% of the physicians received training to operate it.

RESULTS:

The most common records involve data related to consultations (90.1%) and interviews with physical examination (67.1%). Physicians cited that information storage (75.6%), agility, and feasibility of recording (55.1%) were the main advantages of the electronic patient record. As disadvantages, problems in electronic equipment (69.7%) and system errors (65%) were reported. Most participants considered that the implementation had a positive impact on work dynamics (75.6%) and productivity (66.7%), mainly regarding the components "Work processes" (57.3%) and "Amount of carried out activities" (21.4%). Keeping records was significantly associated with the job position (p<0.001), type of unit (p=0.008), time of implementation (p<0.001), and participation in training (p=0.028).

CONCLUSION:

The implementation of the electronic patient record in the Air Force was recently done, and just over half of the physicians were trained prior to the implementation. The tool is considered compatible with work processes and has a positive effect on productivity.

KEYWORDS:
Electronic health records; Health information systems; Health planning

Variables		n	%
Sex
	Female	133	56.8
	Male	101	43.2
Age range (years)
	≤35	85	36.3
	≥35	149	63.7
Rank in the Air Force
	Lieutenant	120	51.2
	Captain	60	25.6
	Major	36	15.4
	Colonel	10	4.3
	Lieutenant colonel	8	3.5
Time since graduation (years)
	<5	31	13.2
	6–20	162	69.2
	>20	41	17.6
Work experience as a physician in the Air Force (years)
	Up to 5 years	99	42.3
	6–15 years	86	36.8
	16 years or more	49	20.9
Type of unit where they work
	Health Squad	85	36.3
	Hospital	130	55.6
	Other	19	8.1

Implementation				Use
Variables		n	%	Variables		n	%
Time				Time
	≤3 years	151	64.5		≤2 years	172	73.5
	>3 years	66	28.2		>2 years	62	26.5
	Does not know	10	4.3	EPR records
	Under implementation	7	3.0		Yes	211	90.2
Participation in training					No	9	3.9
	Yes	190	81.2		Sometimes	14	5.9
	No	44	18.8	Did you stop using it at some point?
Duration of training					Yes	171	73.1
	Up to 1 month	169	88.9		No	63	26.9
	Up to 6 months	6	3.2	Reasons for not using EPR
	EPR records	3	1.6		Structural	151	88.4
	Does not know	12	6.3		Work dynamics	10	5.8
Training before the implementation					Other	10	5.8
	Yes	131	56.0
	No	103	44.0

Variables		Data recording in EPR			p-value
Variables		Yes n (%)	No n (%)	Sometimes n (%)	p-value
Rank in Air Force					<0.001^† † Fisher's exact test. Source: study data.
	Lieutenant	112 (93.4)	1 (0.8)	7 (5.8)
	Captain	55 (91.7)	1 (1.7)	4 (6.6)
	Major	27 (75.0)	7 (19.4)	2 (5.6)
	Colonel	10 (100.0)	0	0
	Lieutenant colonel	7 (87.5)	0	1 (12.5)
Type of unit where they work					0.008^† † Fisher's exact test. Source: study data.
	Health Squad	73 (85.9)	3 (3.5)	9 (10.6)
	Hospital	124 (95.4)	4 (3.1)	2 (1.5)
	Other	14 (73.7)	2 (10.5)	3 (15.8)
Time of EPR implementation at the unit					<0.001^† † Fisher's exact test. Source: study data.
	Up to 6 months	37 (90.2)	1 (2.5)	3 (7.3)
	6 months to 1 year	30 (85.7)	1 (2.9)	4 (11.4)
	1–2 years	71 (94.6)	2 (2.7)	2 (2.7)
	3–5 years	58 (95.1)	1 (1.6)	2 (3.3)
	5 years or longer	0	4 (80.0)	1 (20.0)
	Under implementation	1 (14.3)	4 (57.1)	2 (28.6)
	Does not know	10 (100.0)	0	0
Participation in training to operate EPR					0.028^‡ ‡ Chi-square test.
	Yes	176 (92.6)	5 (2.6)	9 (4.8)
	No	35 (79.5)	4 (9.1)	5 (11.4)
Prior training to EPR implementation					0.733^‡ ‡ Chi-square test.
	Yes	118 (90.1)	6 (4.6)	7 (5.3)
	No	93 (90.3)	3 (2.9)	7 (6.8)

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[1] *Corresponding author: geraldobezerrajr@unifor.br

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Implementation and use of electronic patient records in the Brazilian Air Force: a cross-sectional study1

SUMMARY

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Implementation and use of electronic patient records in the Brazilian Air Force: a cross-sectional study¹