The Impact of Introducing an Electronic Medical Record on the Use of Health Information Exchange in the Emergency Department

Whereas physicians access multiple systems in search of information about patients, there is little research on how their use of one system is affected by the introduction of another system. This research-in-progress examines how the use of a health information exchange system (HIE) by physicians treating critically-ill patients in the emergency department is affected by the introduction of an electronic medical record (EMR). We test how the number of screens viewed (volume) and the time devoted to each screen (duration) are affected by variables characterizing the patient, physician, situation, and available information, and how these effects are moderated by EMR availability. Our preliminary results show that following EMR implementation, physicians access the HIE less frequently and view the same number of screens, yet they devote more time to each screen. Moderation effects suggest that the context of use is crucial to understanding system complementarity and substitution in health information ecosystems.