The Introduction of an Electronic Patient Care Information System and Health Care Providers' Job Stress: A Mixed-Methods Case Study

In this paper, the authors explore how the introduction of an electronic Patient Care Information System (PCIS) relates to changes in health care providers' (HCPs') perceptions of computer use, quality of patient care and job stress. Data were collected using a mixed-methods case study approach over a 20 month period following the introduction of this system. Initially stress levels appeared to increase, but over time declined significantly. After 3 months, the majority of HCPs reported they spent more time entering, retrieving and searching for patient information than before; however, these increases in computer use were unrelated to HCP stress. The potentially negative impact of the system on the quality of patient care was highly correlated with increased job stress. After 20 months, HCPs reported spending less time searching, entering and retrieving patient information, but these indicators of computer use were now highly correlated with stress. While some negative perceptions of the impact of the PCIS declined over time, HCPs reported ongoing stress related to concerns about quality of patient care even after 20 months of use.