Free Research Proposal On Research In Health Professional Education
Introduction and BackgroundIntroduction Many industries in the contemporary world have had to embrace technology in order to not only improve their performance, but also compete favorably. This is not any different for players in health care. Electronic medical records are seen as tools through which policy, practice and research in the fields of interdisciplinary primary healthcare and family medicine can be improved (Garg et al., 2005). A review of the literature shows that the use of electronic medical records improves practice by offering point-of-care information. The point-of-care information is important in assisting clinical decision-making (Garg et al., 2005). Additionally, the point-of-care information through the use of electronic medical records gives feedback on relevant standards of care, thereby leading to improvements in the management of patients (Mitchell et al., 2005). Electronic medical records allow physicians to explore more powerful and sustainable quality improvement programs. This enabling technology allows the contemporary physician to contribute to the much needed improvements in health care.Background Despite the numerous benefits in the use of electronic medical records, only a small number of physician practices utilize electronic medical records (Miller & Sim, 2004). In the national context, statistics on the use of electronic medical records show a low, but increasing adoption rate. As of 2006, only 10% of the hospitals in the United States had fully integrated electronic medical record systems, even if the platform had been in existence for over 30 years. More recent statistics from the survey carried out by DesRoches et al., (2008) showed that 80% of primary care physicians, 83% of all physicians and 86% of physicians not working in primary care did not use electronic medical records. Statistics from the National Ambulatory Medical Care Survey in 2009 showed that 51.7% of physicians who operate from offices did not have or use electronic medical records systems (Hsiao et al 2010). Miller & Sim (2004) argue that several barriers exist towards the integration of electronic medical record systems in physician practices. In their qualitative study, Miller & Sim (2004) found that some of the barriers included the cost implications and the need for expertise in navigating the system. Based on the fact that quality improvement in health care is dependent on the use of electronic medical record systems by physicians, it is important to identify the barriers to integration. This is the first step towards overcoming these barriers through policy interventions, by that improving service delivery and patient management in health care institutions. Research Question, Objectives and HypothesisResearch question The aim of this research proposal is to identify the barriers towards the integration of electronic medical record systems in physician practice. In order to accomplish this aim, the study will be guided by the following research question:What are the barriers affecting the integration of electronic medical records systems in physician practices?Objectives The objectives of this study are not just aimed at directly answering the research question. They are also design to aid in the collection of supporting information, by that creating a context upon which the information collected on the barriers affecting the integration of electronic medical record systems in physician practice can be analyzed. With this in mind, the following are the objectives of the research proposal:1. To determine the number of physicians practices using electronic medical record systems.2. To determine the number of physician practices not using electronic medical record systems, but have budgeted for them in the next two financial years.3. To determine the challenges faced by the physician practices who have integrated electronic medical record systems.4. To establish the barriers for the physician practices who have not integrated electronic medical record systems.5. To establish the intent for the physician practices who have not integrated electronic medical record systems and have not budgeted for them in the next two financial years.HypothesisThe study will seek to test the following hypothesis:H1 The cost implication is not a significant barrier to the integration of electronic medical records in physician practice.Ho There is not intent to integrate electronic medical records in physician practice. MethodologyResearch design The study into the barriers affecting the integration of electronic medical records in physician practice will use mixed methods. More precisely, the study will employ both quantitative and qualitative approaches. The mixed method approach is very appropriate for this study because of the need to test existing hypothesis at the same time generating new hypotheses. In using the quantitative approach, more precisely a survey, the study will explore existing perspectives regarding the barriers affecting the integration of electronic medical records in physician practice and also test the hypothesis upon which the study is based (Bruce, Pope & Stanistreet, 2008). In using the qualitative approach, more precisely the focus group discussion, the study will generate new information regarding the barriers affecting the integration of electronic medical records in physician practice. Additionally, this approach will generate in-depth information that is important in understanding the phenomena under study (Saini & Shlonsky, 2012). When the two approaches are used together, the quantitative approach provides a context upon which the qualitative data can be understood.Study Population The study population in this research is comprised of physician champions and electronic medical records manager. Even though this looks rather simple, the composition of the study population will be designed to enable to researcher to acquire a broad spectrum of information on the barriers affecting the integration of electronic medical records in physician practice. The composition of the study population will reflect diversity in terms of the size of the physician organization, the type of electronic medical records systems used, affiliations, duration for which the physician organization has used the electronic medical record system and the degree of capitated payments.Sample Size Using these criterions, the researcher will sample nine large physician organizations eighteen small physician practices and three mid-sized physician practices. The inclusion and exclusion criteria are that the large physician organizations should comprise of over seventy physicians each. The mid-sized physician organizations should comprise of between thirty and forty physicians each. The small physician practices should comprise of at most ten physicians each.Sampling Method In choosing the study sample, the researcher will use the purposive sampling method. The purposive sampling technique is appropriate for the study because the information sought by the researcher is found with a select type of people. While many more people may be willing to take part in the study, these selected individuals are best placed to provide the right information in terms of depth and relevance (Ray, 2012).Data Collection As highlighted earlier, the researcher will employ mixed methods in this study. In the quantitative approach, the researcher will use a structured questionnaire to explore the different aspects as guided by the central research question and the study objectives. For the qualitative approach the researcher will employ a moderated focus group discussion. The deliberations of the participants will be recorded using a digital recorder.Data Analysis The quantitative data collected from the survey will be analyzed using the Statistical Package for Social Sciences. Data analysis will look for correlations between different variables among other outcomes. The qualitative data will be transcribed and coded for common and repetitive themes.Significance In the broad sense, the outcomes of this study are significant for the improvement of patient management and the quality of service delivery in health care. As highlighted earlier, the point-of-care information is important in assisting clinical decision-making (Garg et al., 2005). Additionally, the point-of-care information through the use of electronic medical records gives feedback on relevant standards of care, thereby leading to improvements in the management of patients (Mitchell et al., 2005). In a more specific sense, the outcomes of this study will increase the understanding of the barriers affecting the integration of electronic medical record systems in physician practice. This will further inform policy interventions to overcome these barriers so that more physician practices can benefit from the diverse advantages of electronic medical record systems.Project Feasibility The research team consists of several members. The researcher is responsible for the coordination of the research efforts as guided by the proposal. The researcher will train the research assistants on the concept of the research, the study design, the sampling techniques and procedure, data collection process and the data collection instruments. The researcher is also responsible for quality control and assurance during the data collection phase. In this regard, special attention is required in collecting qualitative data in order to ensure that the probes used are exhaustive so that the data collected is both in-depth and relevant to the phenomena under study. To facilitate this, the researcher is the custodian of all the resources; monetary and logistic. The other members of the research team are the research assistants. The role of the researcher assistants is to assist in the data collection process under the guidance of the researcher. In order to facilitate them in carrying out their responsibilities, resources such as data collection instruments and financial means will be advanced by the researcher. Expected Contributions and Knowledge Transfer PlanExpected Contributions This study in its entirety confers various contributions to the associate research field. Scientists have used different methodologies and approaches in researching the barriers affecting the integration of electronic medical records in physician practice. In this regard, the mixed method approach is being subconsciously piloted in this study. The success of this study will serve to vindicate the use of this methodology in further studies of the same phenomenon. Additionally, the study will provide grounding upon which future studies in the same phenomenon can be based.Knowledge Transfer Plan The knowledge transfer plan is a very important in research as it involves the dissemination of the information derived from the study to the audience. As such, the knowledge transfer plan should be modeled to suit the audience. Several models of knowledge transfer have been developed. The knowledge transfer plan for this research will be the exchange model. This is in acknowledgement of the existing relationship between the researcher and the organization. In order to enhance the uptake of the information, the knowledge transfer plan will embrace the use of active engagement. In order to supplement this approach, the researcher will make reports that will be submitted to the organization (Reardon, Lavis & Gibson, 2006).
Bruce, N., Pope, D., & Stanistreet, D. (2008). Quantitative methods for health research: A practical interactive guide to epidemiology and statistics. Chichester, England: John Wiley & Sons.
Desroches, C., Campbell, E., Rao, S., Donelan, K., Ferris, T., Jha, A., Kaushal, R., Levy, D., Rosenbaum, S., Shields, A. and Blumenthal, D. (2008). Electronic Health Records in Ambulatory Care — A National Survey of Physicians. New England Journal of Medicine 359: 50–60.
Garg A., Adhikari N., McDonald H., Rosas-Arellano, M., Devereaux, P., Beyene, J., Sam, J. and Haynes, R. (2005). Effects of Computerized Clinical Decision Support Systems on Practitioner Performance and Patient Outcomes: A Systematic Review. Journal of the American Medical Association. 293:1223–38.
Hsiao, C. et al (2010). "Electronic Medical Record/Electronic Health Record Systems of Office- based Physicians: United States, 2009 and Preliminary 2010 State Estimates". NCHS Health E-Stat. CDC/National Center for Health Statistics.
Miller, R. and Sim, I. (2004). Physicians’ Use Of Electronic Medical Records: Barriers And Solutions. Health Affairs. 23: 116-126
Mitchell, E., Sullivan, F., Grimshaw, J., Donnan, P., Watt, G. (2005). Improving Management of Hypertension in General Practice: A Randomised Controlled Trial of Feedback Derived from Electronic Patient Data. British Journal of General Practice. 55:94–101.
Ray. A. (2012). The methodology of sampling and purposive sampling. Munich. GRIN Verlag
Reardon, R., Lavis, J. and Gibson, J. (2006). From Research to Practice: A Knowledge Transfer Planning Guide. Institute for Work & Health. Retrieved 22 Feb. 2015 from http://www.iwh.on.ca/from-research-to-practice
Saini, M., & Shlonsky, A. (2012). Systematic synthesis of qualitative research. New York: Oxford University Press.
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