评估临床工作人员对EHR可用性,满意度和适应新EHR的看法:一个多站点,前后实施研究
Courtney J Diamond1, Jonathan E Elias2,3, Rachel Y Lee1
1Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, United States.
实施新的电子健康记录 (EHR) 提高了临床医生的工作生活质量和效用,但降低了人们感知的易用性. 调查结果可以指导减少与电子健康记录相关的负担和倦怠的努力.
科学领域:
- 医疗信息学 医疗信息学
- 临床工作流分析分析
- 人与计算机在医疗保健中的互动
背景情况:
- 电子健康记录 (EHR) 显著改变了临床实践,可能会增加文档负担和临床医生倦怠.
- 评估EHR可用性对于减轻对医疗保健专业人员的负面影响至关重要.
- 了解影响EHR采用和满意度的因素是优化系统实施的关键.
研究的目的:
- 在新EHR系统实施之前和之后,评估集团层面对EHR可用性的看法.
- 测量临床人员适应新EHR系统的情况.
- 确定临床角色,环境和专业对EHR可用性和适应性的影响.
主要方法:
- 采用健康信息技术可用性评估量表 (Health-ITUES) 和健康信息技术适应性调查的实施前后调查.
- 统计分析包括未配对的t测试和多途径差异分析 (MANOVAs) 与邦费罗尼校正.
- 从同一卫生系统内的两个学术医疗中心 (AMC) 的临床工作人员收集的数据.
主要成果:
- 工作生活质量 (QWL),感知有用性 (PU) 和用户控制 (UC) 的感知在实施后总体上有所改善.
- 在EHR实施后,感知易用性和认知支持/情境意识得分下降.
- 根据临床角色,环境 (例如,急诊室) 和专业 (例如,紧急医疗,重症监护) 观察到可用性和适应性得分的显著差异.
结论:
- 新的EHR实施可以增强临床医生经验的某些方面,如QWL,PU和UC.
- 感知易用性和认知支持的下降凸显了系统改进的领域.
- 针对特定角色,环境和专业的量身定制策略是必要的,以优化EHR的可用性并最大限度地降低临床医生的负担.
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