Miller Robert H, Sim Ida
Institute for Health and Aging, University of California, San Francisco, USA.
Health Aff (Millwood). 2004 Mar-Apr;23(2):116-26. doi: 10.1377/hlthaff.23.2.116.
The electronic medical record (EMR) is an enabling technology that allows physician practices to pursue more powerful quality improvement programs than is possible with paper-based records. However, achieving quality improvement through EMR use is neither low-cost nor easy. Based on a qualitative study of physician practices that had implemented an EMR, we found that quality improvement depends heavily on physicians' use of the EMR-and not paper-for most of their daily tasks. We identified key barriers to physicians' use of EMRs. We then suggest policy interventions to overcome these barriers, including providing work/practice support systems, improving electronic clinical data exchange, and providing financial rewards for quality improvement.
电子病历(EMR)是一种赋能技术,它使医生执业机构能够开展比纸质记录更强大的质量改进项目。然而,通过使用电子病历实现质量改进既不低成本也不容易。基于对已实施电子病历的医生执业机构的定性研究,我们发现质量改进在很大程度上取决于医生在日常任务的大部分工作中使用电子病历而非纸质病历。我们确定了医生使用电子病历的关键障碍。然后,我们建议采取政策干预措施来克服这些障碍,包括提供工作/执业支持系统、改善电子临床数据交换以及为质量改进提供经济奖励。