从"地方控制"到"依赖":向单一供应商集成电子健康记录系统的过渡及其对EHR工作人员的影响
Julian Brunner1, Ekaterina Anderson2,3, David C Mohr4,5
1Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA. julian.brunner@va.gov.
Journal of general internal medicine
|October 5, 2023
概括
采用综合电子健康记录 (EHR) 系统减少了EHR员工的自主权,并改变了关键的专业职能. 医疗保健领导人应该通过修订职位角色和加强治理来为这些影响做好准备.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健管理的管理
- 组织行为 组织行为
背景情况:
- 医疗保健系统正在从单一的传统或最好的电子健康记录系统转向集成的单一供应商解决方案.
- 这些转变对EHR内部工作人员的影响,对于系统治理和支持至关重要,仍然未得到充分研究.
研究的目的:
- 确定采用集成的,单一供应商的EHR系统对机构EHR工作人员的感知影响.
主要方法:
- 定性研究涉及半结构化的电话采访,对42名员工进行了采访,这些员工来自美国四个医疗保健系统,这些医疗保健系统最近采用了集成的电子健康记录.
- 采访被转录并使用定性内容分析进行分析.
主要成果:
- 参与者报告说,在采用综合EHR后,个人和机构层面的自主权丧失.
- 电子健康管理工作人员的关键专业职能,包括沟通,治理,优化和教育,经历了重大转型.
结论:
- 集成的EHR转型深刻影响EHR员工的自主性和专业角色.
- 机构应该主动管理这些变化,更新职位描述,加强电子健康记录治理,吸引前线临床医生,并组织供应商合同,以保持自主性.
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