美国家庭医学住院医师培训项目中电子病历的趋势、认知及使用模式分析。
An analysis of trends, perceptions, and use patterns of electronic medical records among US family practice residency programs.
作者信息
Lenhart J G, Honess K, Covington D, Johnson K E
机构信息
New Hanover Regional Medical Center Residency in Family Medicine, Wilmington, NC, USA.
出版信息
Fam Med. 2000 Feb;32(2):109-14.
BACKGROUND AND OBJECTIVES
This study intended to quantify electronic medical record (EMR) use in family practice residencies, associate program characteristics with EMR use, and identify perceptions and issues about the use of EMRs.
METHODS
A survey was mailed to all 454 US family practice residency programs, with a 72% response rate. The survey, which was pretested and revised, was designed to identify benefits, problems, perceptions, and trends regarding the use of EMRs.
RESULTS
Fifty-five of 329 programs (17%) were using an EMR, while 10 (3%) had used an EMR but discontinued. Programs in the South reported the highest EMR use (21%, 21/99), and those in the North Central region reported the lowest use (11%, 11/102). EMR use was highest in university settings (19%, 15/81), programs offering fellowships (26%, 24/92), new programs (36%, 18/48), and programs that require research (22%, 20/91). Of the 329 programs that responded, 43% (143 programs) reported having information systems (IS) committees. Of the 55 programs currently using EMRs, 78% had at least one full-time equivalent IS technician. Of programs that discontinued use, software inadequacy was the most frequently cited reason (40%, 4/10). Programs that had never used EMR systems (n = 264) were more likely than those that had used EMRs (n = 65) to favorably perceive EMRs with respect to 1) meeting program requirements (44% versus 34%), 2) documenting improved patient care (65% versus 43%), 3) providing a reliable research database (94% versus 55%), and 4) documenting resident experience (92% versus 53%). Of the 264 (80%) programs that had never used an EMR, 172 (65%) plan to implement one.
CONCLUSIONS
EMR use is low among US family practice residency programs, but some success in implementation of EMRs has been achieved. Based on the responses to this survey, use will likely increase from 55 of 329 programs (17%) to 153 of 329 (47%) by 2000.
背景与目的
本研究旨在量化家庭医学住院医师培训项目中电子病历（EMR）的使用情况，将项目特征与EMR使用情况相关联，并确定对EMR使用的看法和问题。
方法
向美国所有454个家庭医学住院医师培训项目邮寄了一份调查问卷，回复率为72%。该调查问卷经过预测试和修订，旨在确定与EMR使用相关的益处、问题、看法和趋势。
结果
329个项目中有55个（17%）正在使用EMR，而10个（3%）曾使用过EMR但已停止使用。南部的项目EMR使用率最高（21%，21/99），中北部地区的项目使用率最低（11%，11/102）。大学环境中的项目EMR使用率最高（19%，15/81），提供奖学金的项目（26%，24/92）、新项目（36%，18/48）以及要求开展研究的项目（22%，20/91）也是如此。在回复的329个项目中，43%（143个项目）报告设有信息系统（IS）委员会。在目前使用EMR的55个项目中，78%至少有一名全职等效的IS技术人员。在停止使用的项目中，软件不足是最常被提及的原因（40%，4/10）。从未使用过EMR系统的项目（n = 264）比使用过EMR的项目（n = 65）更倾向于积极看待EMR，具体体现在以下方面：1）满足项目要求（44%对34%），2）记录改善的患者护理情况（65%对43%），3）提供可靠的研究数据库（94%对55%），4）记录住院医师的经验（92%对53%）。在264个（80%）从未使用过EMR的项目中，172个（65%）计划实施EMR。
结论
美国家庭医学住院医师培训项目中EMR的使用率较低，但在EMR的实施方面已取得一些成功。根据本次调查的回复情况，到2000年，使用率可能会从329个项目中的55个（17%）增加到329个中的153个（47%）。
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