Aaronson J W, Murphy-Cullen C L, Chop W M, Frey R D
Parkland Memorial Family Practice Residency Program, University of Texas Southwestern Medical Center at Dallas, USA.
Fam Med. 2001 Feb;33(2):128-32.
Few studies have included family practice residents' perceptions regarding the use of electronic medical records (EMR) in a residency program. This study determined residents' perceptions of EMR systems and what variables influenced those perceptions. Specifically, we studied how EMR training and previous computer background influenced resident perception of difficulty in EMR implementation, time efficiency, preventive care opportunities, accuracy of medical records, and desired future use of EMR systems. Questions targeted the use of the EMR in the resident continuity clinic.
Survey questionnaires about the use of EMR systems in the residents' continuity clinic were mailed to residency directors and residents of 219 family practice residency programs. Respondents were given the opportunity to comment on benefits of and concerns about EMR.
Resident response rate was 46% in programs using EMR systems. Findings revealed that the length of EMR training a resident received was unrelated to the perceived adequacy of training but was related to the residents' assessment of the difficulty of implementing the EMR in their continuity clinic. Residents who perceived training to be adequate and perceived a relative ease of implementing the EMR were more likely to perceive the EMR to be beneficial and were more likely to choose the EMR over traditional paper records for future use. Computer background/experience was not related to perceived satisfaction with the EMR, nor was it related to perceived difficulty of implementation, adequacy of training, or anticipated future use of an EMR system.
Although residents recognize the benefits of the EMR, our study demonstrates an overall ambivalence and frustration toward EMR systems currently in use in family practice residency continuity clinics. However, the training they receive regarding EMR use in their residency may influence not only the perceived ease of EMR implementation but attitudes regarding the ability of the EMR to assist them with preventive opportunities, time management, and medical record accuracy. This may in turn have influence on the use of EMR systems in their practices after residency.
很少有研究涉及家庭医学住院医师对住院医师培训项目中电子病历（EMR）使用的看法。本研究确定了住院医师对电子病历系统的看法以及影响这些看法的变量。具体而言，我们研究了电子病历培训和以前的计算机背景如何影响住院医师对电子病历实施难度、时间效率、预防保健机会、病历准确性以及电子病历系统未来期望使用情况的看法。问题针对住院医师连续性诊所中电子病历的使用。
关于住院医师连续性诊所中电子病历系统使用情况的调查问卷被邮寄给219个家庭医学住院医师培训项目的项目主任和住院医师。受访者有机会对电子病历的益处和担忧发表评论。
使用电子病历系统的项目中，住院医师的回复率为46%。研究结果显示，住院医师接受电子病历培训的时长与所感知的培训充分性无关，但与住院医师对在其连续性诊所实施电子病历难度的评估有关。那些认为培训充分且认为实施电子病历相对容易的住院医师更有可能认为电子病历有益，并且在未来使用中更有可能选择电子病历而非传统纸质病历。计算机背景/经验与对电子病历的感知满意度无关，也与感知的实施难度、培训充分性或电子病历系统的预期未来使用情况无关。
尽管住院医师认识到电子病历的益处，但我们的研究表明，目前家庭医学住院医师连续性诊所中使用的电子病历系统总体上存在矛盾心理和挫败感。然而，他们在住院医师培训期间接受的关于电子病历使用的培训不仅可能影响对电子病历实施难易程度的感知，还可能影响对电子病历在预防保健机会、时间管理和病历准确性方面帮助他们的能力的态度。这反过来可能会影响他们住院医师培训结束后在实践中对电子病历系统的使用。
