政策背景和数字发展:加拿大4个学术卫生中心30年来发展轨迹的比较研究
Aude Motulsky1,2, Susan Usher2, Pascale Lehoux1
1School of Public Health, Université de Montréal, Montreal, QC H3N 1X9, Canada.
概括
由于政府和组织策略不一致,北克学术健康中心 (AHCs) 的健康记录数字化面临挑战. 改善协调对于有效的电子健康记录 (EHR) 实施和数字成熟度至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健服务研究 医疗服务研究
- 数字化健康转型
背景情况:
- 医疗记录的数字化是改善临床,行政和政策决策的关键.
- 学术健康中心 (AHCs) 在推动医疗系统内数据驱动的改进方面发挥着关键作用.
- 尽管正在努力,数字健康记录的采用和利用方面的挑战仍然存在.
研究的目的:
- 探索北克AHC的数字化轨迹.
- 了解组织与政府战略之间的紧张关系对数字发展的影响.
- 分析影响电子健康记录 (EHR) 实施的因素.
主要方法:
- 采用了回顾性案例研究设计.
- 数据收集涉及纪录,观察和采访方法.
- 在四个北克AHC的30多年的数字化努力进行了比较.
主要成果:
- 系统层面的战略从支持自下而上的倡议转向对临床信息系统的高度规范性协调.
- 由于卫生系统重组和对EHR的内部选择,AHCs对这些转变的体验不同.
- 尽管有努力,但在所有四个AHC中,数字成熟度仍然很低.
结论:
- 北克早期的数字化发展忽视了系统和组织战略之间的协调.
- 强烈的处方和耐药性突出显示了AHC和系统级目标之间的紧张关系.
- 将自上而下的指导与组织自主性的平衡,对于成功实施EHR和数字能力建设至关重要.
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