{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T10:09:41Z","timestamp":1775124581949,"version":"3.50.1"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Electronic health records (EHRs) have become widely adopted with increasing emphasis on improving care delivery. Improvements in surgery may be limited by specialty-specific issues that impact EHR usability and engagement. Accordingly, we examined EHR use and perceptions in urology, a diverse surgical specialty.<\/jats:p><jats:p>\n          Methods\u2003We conducted a national, sequential explanatory mixed methods study. Through the 2019 American Urological Association Census, we surveyed urologic surgeons on EHR use and perceptions and then identified associated characteristics through bivariable and multivariable analyses. Using purposeful sampling, we interviewed 25 urologists and applied coding-based thematic analysis, which was then integrated with survey findings.<\/jats:p><jats:p>\n          Results\u2003Among 2,159 practicing urologic surgeons, 2,081 (96.4%) reported using an EHR. In the weighted sample (n\u2009=\u200912,366), over 90% used the EHR for charting, viewing results, and order entry with most using information exchange functions (59.0\u201379.6%). In contrast, only 35.8% felt the EHR increases clinical efficiency, whereas 43.1% agreed it improves patient care, which related thematically to information management, administrative burden, patient safety, and patient\u2013surgeon interaction. Quantitatively and qualitatively, use and perceptions differed by years in practice and practice type with more use and better perceptions among more recent entrants into the urologic workforce and those in academic\/multispecialty practices, who may have earlier EHR exposure, better infrastructure, and more support.<\/jats:p><jats:p>\n          Conclusion\u2003Despite wide and substantive usage, EHRs engender mixed feelings, especially among longer-practicing surgeons and those in lower-resourced settings (e.g., smaller and private practices). Beyond reducing administrative burden and simplifying information management, efforts to improve care delivery through the EHR should focus on surgeon engagement, particularly in the community, to boost implementation and user experience.<\/jats:p>","DOI":"10.1055\/s-0043-1763513","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T23:20:42Z","timestamp":1681341642000},"page":"279-289","source":"Crossref","is-referenced-by-count":8,"title":["Electronic Health Record Use and Perceptions among Urologic Surgeons"],"prefix":"10.1055","volume":"14","author":[{"given":"Hung-Jui","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene E.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gotz","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"School of Information and Library Science, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison M.","family":"Deal","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hillary M.","family":"Heiling","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randall","family":"Teal","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Connected Health Applications and Interventions Core, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maihan B.","family":"Vu","sequence":"additional","affiliation":[{"name":"Connected Health Applications and Interventions Core, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William D.","family":"Meeks","sequence":"additional","affiliation":[{"name":"Data Management and Statistical Analysis, American Urological Association, Linthicum, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Fang","sequence":"additional","affiliation":[{"name":"Data Management and Statistical Analysis, American Urological Association, Linthicum, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia V.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew E.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan","family":"Basch","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States"},{"name":"Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"e215503","DOI":"10.1001\/jamanetworkopen.2021.5503","article-title":"Assessment of potentially preventable hospital readmissions after major surgery and association with public vs private health insurance and comorbidities","volume":"4","author":"C S Brown","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/SLA.0000000000003165","article-title":"Understanding the costs associated with surgical care delivery in the Medicare population","volume":"271","author":"D R Kaye","year":"2020","journal-title":"Ann 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Jamoom","year":"2016","journal-title":"J Health Med Inform"},{"issue":"03","key":"ref39","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1001\/jamasurg.2020.5670","article-title":"Practice characteristics and job satisfaction of private practice and academic surgeons","volume":"156","author":"S T Mahoney","year":"2021","journal-title":"JAMA Surg"},{"issue":"10","key":"ref40","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s00345-018-2293-8","article-title":"Implementation of medical scribes in an academic urology practice: an analysis of productivity, revenue, and satisfaction","volume":"36","author":"B J McCormick","year":"2018","journal-title":"World J Urol"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"e228301","DOI":"10.1001\/jamanetworkopen.2022.8301","article-title":"Assessment of satisfaction with the electronic health record among physicians in physician-owned vs non-physician-owned practices","volume":"5","author":"L S Rotenstein","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"05","key":"ref42","doi-asserted-by":"crossref","first-page":"e2211973","DOI":"10.1001\/jamanetworkopen.2022.11973","article-title":"Performance of a machine learning algorithm using electronic health record data to predict postoperative complications and report on a mobile platform","volume":"5","author":"Y Ren","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"02","key":"ref43","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1001\/jamasurg.2019.4917","article-title":"Artificial intelligence and surgical decision-making","volume":"155","author":"T J Loftus","year":"2020","journal-title":"JAMA Surg"},{"issue":"02","key":"ref44","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/UPJ.0000000000000198","article-title":"Characteristics of participants in the American Urological Association Quality (AQUA) Registry and early impact of participation on quality of care","volume":"8","author":"J B Shelton","year":"2021","journal-title":"Urol Pract"}],"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1763513.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T23:20:55Z","timestamp":1681341655000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1763513"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":32,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2023,3,15]]},"published-print":{"date-parts":[[2023,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1763513","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1869-0327"],"issn-type":[{"value":"1869-0327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}