远程医疗强度的医生电子健康记录使用的差异:来自2个学术医疗中心的证据
Seunghwan Kim1,2, Robert Thombley3, Elise Eiden4
1Roy and Diana Vagelos Division of Biology and Biomedical Sciences, Washington University School of Medicine in St Louis, Saint Louis, MO 63110, United States.
概括
远程医疗的使用增加显著改变了医生电子健康记录 (EHR) 的流行后使用. 更多的EHR时间表明工作负载轮班,而较少的订单表明虚拟护理的局限性,突出了优化EHR支持的需要.
科学领域:
- 医疗信息学 医疗信息学
- 医疗信息学 医疗信息学
- 数字健康数字健康
背景情况:
- 随着COVID-19的流行,远程医疗的普及加速了.
- 了解远程医疗对医生电子健康记录 (EHR) 使用的影响对于优化医疗保健提供至关重要.
- 以前的研究还没有完全阐明与不同远程医疗强度相关的电子病历使用模式的具体变化.
研究的目的:
- 评估远程医疗使用的强度与在COVID-19后时代的门诊医生EHR利用之间的关联.
- 确定受远程医疗采用增加影响的特定EHR任务.
- 探索远程医疗对电子病历使用的影响的机构差异.
主要方法:
- 在两个主要的学术医疗中心 (WashU和UCSF) 的11个专业的门诊医生的回顾性分析.
- 在COVID-19后期 (2021年3月至2022年3月) 检查基于时间和基于频率的EHR使用指标.
- 应用具有双向固定效应的多变量回归模型来评估远程医疗强度和电子病历使用之间的关系.
主要成果:
- 完全远程医疗的医生周与两个机构的EHR时间 (每8个预定患者小时的小时) 和文档时间的增加相关.
- 使用远程医疗广泛的医生与使用远程医疗较少的医生相比,订购模式下降.
- 观察到与信息搜索和临床沟通相关的离散EHR任务中的混合模式,表明特定环境的影响.
结论:
- 扩大远程医疗的使用与医生在电子病历参与中的重大转变有关,包括增加时间和改变任务完成.
- 电子医疗记录时间的增加可能反映了医生工作负载的不断变化,而订单减少则表明虚拟护理环境中的潜在限制.
- 电子病历使用模式的机构差异突显了远程医疗的影响的特定背景性质,强调需要量身定制的电子病历优化,以有效支持虚拟护理.
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