{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T02:20:05Z","timestamp":1772677205261,"version":"3.50.1"},"reference-count":47,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR North West London Applied Research Collaboration"},{"name":"Imperial NIHR Biomedical Research Centre"},{"DOI":"10.13039\/501100013631","name":"Patient Safety Translational Research Centre","doi-asserted-by":"crossref","award":["PSTRC-2016-004"],"award-info":[{"award-number":["PSTRC-2016-004"]}],"id":[{"id":"10.13039\/501100013631","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,30]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The lack of interoperability has been a well-recognised limitation associated with the use of electronic health records (EHR). However, less is known about how it manifests for frontline NHS staff when delivering care, how it impacts patient care and what its implications are on care efficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>(1) To capture the perceptions of NHS physicians regarding the current state of EHR interoperability, (2) to investigate how poor interoperability affects patient care and safety and (3) to explore the effects it has had on care efficiency in the NHS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online Qualtrics survey was conducted between June and October 2021 to explore how NHS physicians perceived the present state of interoperability among EHR in service, its effects on patient safety and its impact on care efficiency in NHS healthcare facilities. Recruitment was performed via convenience sampling and snowballing in collaboration with contacts at Health Education England deaneries and the Royal College of General Practitioners. Descriptive statistics were used to report any notable findings observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 636 NHS physicians participated, of which 218 (34.3%) completed the survey fully. Participants reported that EHR interoperability is rudimentary across much of the NHS, with limited ability to read but not edit data from within their organisation. Negative perceptions were most pronounced among specialties in secondary care settings and those with less than 1 year of EHR experience or lower self-reported EHR skills. Limited interoperability prolonged hospital stays, lengthened consultation times and frequently necessitated repeat investigations to be performed. Limited EHR interoperability impaired physician access to clinical data, hampered communication between providers and was perceived to threaten patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As healthcare data continues to increase in complexity and volume, EHR interoperability must evolve to accommodate these growing changes and ensure the continued delivery of safe care. The experiences of physicians provide valuable insight into the practical challenges limited interoperability poses and can contribute to future policy solutions to better integrate EHR in the clinical environment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-096669","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T23:25:28Z","timestamp":1749597928000},"page":"e096669","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Physician experiences of electronic health record interoperability and its practical impact on care delivery in the English NHS: a cross-sectional survey study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8209-4490","authenticated-orcid":false,"given":"Edmond","family":"Li","sequence":"first","affiliation":[{"name":"Global Digital Health Unit, Department of Primary Care and Public Health, Imperial College London, London, UK"},{"name":"Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0906-0339","authenticated-orcid":false,"given":"Olivia","family":"Lounsbury","sequence":"additional","affiliation":[{"name":"Global Digital Health Unit, Department of Primary Care and Public Health, Imperial College London, London, UK"}]},{"given":"Mujtaba","family":"Hasnain","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, University of Manchester, Manchester, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1668-0672","authenticated-orcid":false,"given":"Hutan","family":"Ashrafian","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7107-7211","authenticated-orcid":false,"given":"Ana Luisa","family":"Neves","sequence":"additional","affiliation":[{"name":"Global Digital Health Unit, Department of Primary Care and Public Health, Imperial College London, London, UK"},{"name":"Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK"},{"name":"Center for Health Technology and Services Research, Department of Community Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1495-7746","authenticated-orcid":false,"given":"Jonathan","family":"Clarke","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK"},{"name":"Centre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, UK"}]}],"member":"239","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"2025101814504845000_15.6.e096669.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12911-019-0897-6","article-title":"Delivering person-centered care with an electronic health record","volume":"19","author":"Stanhope","year":"2019","journal-title":"BMC Med Inform Decis Mak"},{"key":"2025101814504845000_15.6.e096669.2","first-page":"50","article-title":"Transforming and improving health care through meaningful use of health information technology","volume":"71","author":"Chin","year":"2012","journal-title":"Hawai\u2019i J Med Public Health: J Asia Pacific Med Public Health"},{"key":"2025101814504845000_15.6.e096669.3","doi-asserted-by":"publisher","DOI":"10.15265\/IYS-2016-s006"},{"key":"2025101814504845000_15.6.e096669.4","doi-asserted-by":"publisher","DOI":"10.1177\/0951484816662492"},{"key":"2025101814504845000_15.6.e096669.5","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-1"},{"key":"2025101814504845000_15.6.e096669.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2012.11.004"},{"key":"2025101814504845000_15.6.e096669.7","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-031637","article-title":"Improving data sharing between acute hospitals in England: an overview of health record system distribution and retrospective observational analysis of inter-hospital transitions of care","volume":"9","author":"Warren","year":"2019","journal-title":"BMJ Open"},{"key":"2025101814504845000_15.6.e096669.8","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(23)00157-7"},{"key":"2025101814504845000_15.6.e096669.9","unstructured":"The Kings Fund . 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