This report describes a 2-year prospective, longitudinal survey of attending physicians in 3 clinical areas (family medicine, general pediatrics, internal medicine) who experienced a transition from a homegrown electronic health record (EHR) to a vendor EHR. Participants were already highly familiar with using EHRs. Data were collected 1 month before and 3, 6, 13, and 25 months post implementation. Our primary goal was to determine if perceptions followed a J-curve pattern in which they initially dropped but eventually surpassed baseline measures. A J-curve was not found for any measures, including workflow, safety, communication, and satisfaction. Only the reminders and alerts measure dropped and then returned to baseline (U-curve); a few remained flatlined. Most dropped and remained below baseline (L-curve). The only measure that remained above baseline was documenting in the exam room with the patient. This study adds to the literature about current controversies surrounding EHR adoption and physician satisfaction.

A near ubiquitous feature of user interfaces is feedback on task completion or progress indicators such as the graphical bar that grows as more of the task is completed. The presumed benefit is that users will be more likely to complete the task if they see they are making progress but it is also possible that feedback indicating slow progress may sometimes discourage users from completing the task. This paper describes two experiments that evaluate the impact of progress indicators on the completion of on-line questionnaires. In the first experiment, progress was displayed at different speeds throughout the questionnaire. If the early feedback indicated slow progress, abandonment rates were higher and users' subjective experience more negative than if the early feedback indicated faster progress. In the second experiment, intermittent feedback seemed to minimize the costs of discouraging feedback while preserving the benefits of encouraging feedback. Overall, the results suggest that when progress seems to outpace users' expectations, feedback can improve their experience though not necessarily their completion rates; when progress seems to lag behind what users expect, feedback degrades their experience and lowers completion rates.

Social interface theory has widespread influence in the field of human-computer interaction. The basic thesis is that humanizing cues in a computer interface can engender responses from users similar to human-human interaction. In contrast, the survey interviewing literature suggests that computer administration of surveys on highly sensitive topics reduces or eliminates social desirability effect, even when such humanizing features as voice are used.