Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
This project used patient experience data to implement low-cost improvements to EMR-enabled outpatient consultations, strengthening interpersonal care without major system change.
Dates: January 2025 - ongoing
Implementation sites: Logan Hospital
HICOP
Aim
To use patient experience insights to improve patient-centred care delivery in an EMR-enabled outpatient clinic.
Outcomes
- High baseline patient-reported experience across communication, trust, continuity of care, and overall satisfaction.
- Identification of specific improvement opportunities related to screen-focused workflows and patient understanding.
- Implementation of four targeted, clinician-led changes without additional funding or EMR build.
- Improved clinician awareness of patient-centred EMR use and more consistent shared screen viewing during consultations.
- High clinician acceptability with minimal workflow disruption.
- Repeat patient experience measurement planned to assess impact over time.
Background
Queensland Health has achieved widespread implementation of electronic medical records (EMRs) across public hospitals, with significant investment focused on safety, efficiency, and clinical documentation. While clinician experience and system performance have been well studied, patient experience in digitally enabled outpatient care remains less well understood.
In outpatient settings, patients do not directly interact with the EMR. Instead, their experience is shaped indirectly through clinicians' use of digital information during consultations, documentation practices, and information continuity across care settings. Existing patient experience measures often report high satisfaction but provide limited insight into how digital workflows influence interpersonal interaction, communication, and engagement.
At Logan Endocrine and Diabetes Services (LEADS), a fully digital diabetes outpatient clinic, findings from a formal patient experience evaluation suggested that while care quality was high, some patients experienced reduced personal interaction during consultations due to screen-focused workflows.
The central problem addressed by this project was how patient experience data could be used to identify actionable, locally feasible improvements to EMR-enabled outpatient care, without relying on major system redesign or additional resources.
Methods
A mixed-methods patient experience study was conducted in a public diabetes outpatient clinic using:
- A validated Patient Experience Monitor (PEM) aligned with Picker principles
- Two open-ended questions to capture contextual patient feedback
Quantitative and qualitative findings were analysed and synthesised to identify strengths and improvement opportunities related to EMR-enabled care delivery.
Results were formally shared with the LEADS multidisciplinary team through team meetings and summary materials highlighting key themes and patient quotes. Rather than pursuing technical EMR changes, the team focused on identifying immediate, clinician-led workflow and behavioural changes that could be implemented using existing system functionality.
Four targeted initiatives were implemented:
- Reduced screen time during discussion-heavy or sensitive parts of consultations
- Streamlined documentation templates to minimise in-consultation data entry
- Routine visual sharing of longitudinal clinical trends (eg HbA1c, glucose, weight) on screen with patients
- Informal peer coaching to support patient-centred EMR use, including signposting screen use and shared viewing
The approach aligned with principles of continuous quality improvement and sociotechnical optimisation, focusing on how technology is used in practice rather than altering the technology itself.
Discussion
Several factors were critical to the project's success. The clinic's digitally mature environment enabled rapid translation of findings without technical barriers. Strong clinician engagement and ownership supported uptake of changes, particularly as initiatives were low-burden and aligned with existing workflows. Presenting patient experience data alongside direct patient quotes increased relevance and credibility for frontline staff.
Key lessons learnt include the value of rapid feedback loops between evaluation and practice, and the importance of addressing interpersonal aspects of digital care that may not be visible in routine performance metrics. Small behavioural and workflow changes were sufficient to address patient-identified issues without additional funding or system modification.
Limitations include the single-site setting and reliance on early observational outcomes rather than formal post-implementation measurement. Patient experience re-measurement is planned to assess sustainability and impact over time.
This project is transferable to other Queensland Health outpatient services using EMRs, particularly chronic disease clinics with longitudinal patient relationships. The approach is scalable, low-cost, and adaptable across varying levels of digital maturity.
Next steps include repeat patient experience measurement, formal documentation of practice changes, and exploration of broader information-sharing initiatives, including patient access to clinical information and improved primary care integration.
References
- Bastemeijer CM et al. Patient Experience Monitor (PEM): Development of short-form Picker questionnaires. Patient Relat Outcome Meas. 2020.
- Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006.
- Sullivan C et al. Queensland Digital Health Clinical Charter. Aust Health Rev. 2020.
- Wang W et al. Clinicians' perspectives on EMR use in diabetes outpatient care. Int J Med Inform. 2026.
Key contact
Wenyong (Jase) Wang
Nurse Practitioner
Metro South Hospital and Health Service