在农村初级保健中实施个人健康记录:使用RE-AIM框架进行描述性探索性研究
Selena Davis1, Mindy A Smith2,3, Lindsay Burton4
1Department of Family Practice, The University of British Columbia, Vancouver, Canada.
PLOS digital health
|June 26, 2024
概括
个人健康记录 (PHR) 提供了一个全面的健康故事和改进的沟通. 然而,互操作性,患者机构和提供者支持方面的挑战阻碍了农村环境中的广泛采用和维护.
科学领域:
- 医疗信息学 医疗信息学
- 患者参与 患者参与
- 农村卫生 农村卫生
背景情况:
- 个人健康记录 (PHR) 正在成为以患者为中心的工具,用于共享决策和医疗数据管理.
- 农村医疗保健机构在采用新的数字健康技术方面面临着独特的挑战.
研究的目的:
- 通过RE-AIM框架探索农村患者和提供者对PHR实施的看法.
- 在农村环境中评估PHR的覆盖范围,有效性,采用,实施和维护.
主要方法:
- 一种混合方法的方法,包括干预前/后的患者调查,提供者采访和行政数据.
- 与患者和提供者进行了焦点小组,以收集实施前和后的观点.
- 该RE-AIM (覆盖范围,有效性,采用,实施,维护) 框架指导了评估.
主要成果:
- 人们认为PHR可以增强沟通并提供全面的健康叙述,患者优先考虑健康促进数据,提供者优先考虑临床数据.
- 评估表明患者接触范围有限 (16%),患者满意度中立,生活质量或自我有效性没有显著变化.
- 诊所的采用程度中等 (44%),偏好在较小,更偏远社区的公共诊所. 关键障碍包括缺乏互操作性和由COVID-19大流行加剧的实施挑战.
- 由于存在重大障碍,所有参与诊所在研究期间停止了PHR的使用.
结论:
- RE-AIM框架提供了对农村环境中PHR影响的全面评估.
- 成功实施PHR的关键障碍包括实现系统互操作性,确保患者代理和控制,并提供足够的提供者培训和支持.
- 未来的PHR计划必须解决这些障碍,以改善农村社区的患者参与和医疗数据管理.
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