Electronic patient records (EPR) as opportunity to promote patients’ role within healthcare? Physiotherapists’ perceptions on EPR and its implementation

This qualitative study aimed to explore physiotherapists’ perceptions and attitude towards the implementation of EPR within their clinical practice.

Three focus groups were organized with twenty physiotherapists, transcribed ‘ad verbatim’, and data were analysed using thematic analysis.

Three levels (macro, meso, micro) were identified. At the macro level, results indicate that there are several obstacles for EPR implementation, such as data protection and reimbursement scheme. At the meso level, criteria that hinder rather than promote the implementation of the EPR in inter-professionalism and in organisations were detected. At the micro level, physiotherapists’ digital competencies are limited, and their attitude and motivation to work with EPR is not very advanced. Additionally, the potential of change physiotherapists’ role and patients’ participation for decision-making is not yet recognized.

Several factors interact among the different levels (systems, institutions, individual).  This complex interplay has multidimensional components which all influence each other.  Physiotherapists have awareness of EPR's importance but are removed from decisions which impact the barriers to implementation except at the level of their own practice.

To proceed and accelerate the systematic implementation of EPR it is important to identify promoting factors on macro, meso and micro levels. 

Based on the results of our pilot study there is potential for co-creation of ideas to meet the needs of health professionals, patients and organizations as well as the Swiss healthcare system. Educational environments would need to include digital skills training, reflection on future professional roles, and opportunities to address attitudes and motivation towards technology at the individual level.  Organizational components could be addressed by pilot implementation projects focusing on processes and relationships within institutions.  Last but not least at the systems level, policy makers need to reconsider incentives to encourage EPR uptake.