Russell Scott C, Spooner S Andrew
Division of General Internal Medicine, University of Tennessee Health Science Center, Memphis 38105, USA.
Tenn Med. 2004 Oct;97(10):457-60.
Although electronic medical records (EMRs) are widely regarded as valuable tools in patient care, physicians in outpatient practices have been slow to adopt them. We sought to determine the current use of EMRs in area practices and identify physician attitudes related to their adoption.
Fax and mail survey of randomly selected physician representatives of all outpatient practices of Internal Medicine (n=51) and Pediatrics (n=24) in Shelby County, Tenn. Scores on eight physician attitudes regarding barriers to EMR adoption were obtained using a Likert scale.
Survey response rate was 55%, with 18% reporting current EMR use. This corresponds to an EMR penetration of 20% for Shelby County. Current users were significantly less likely (P=0.005) than non-users to feel that an EMR interferes with doctor-patient interaction and less likely (P=0.019) to have EMR privacy concerns. While differences noted in other attitudes did not reach statistical significance, a trend was seen toward EMR users being less concerned (P=.0502) about reliability of an EMR. Large practices were no more likely than smaller ones to be using an EMR. Internal Medicine and Pediatric participants responded similarly to all items. The number of years in practice had no demonstrable impact on physician responses to these survey items.
In this West Tennessee physician population, EMR user and non-user attitudes markedly differed about impact on doctor-patient interaction and patient privacy. If such concerns could be addressed to the satisfaction of physicians considering EMRs in their practice, adoption rates might be increased.
尽管电子病历(EMR)被广泛视为患者护理中的宝贵工具,但门诊实践中的医生采用电子病历的速度一直较慢。我们试图确定该地区实践中电子病历的当前使用情况,并确定与采用电子病历相关的医生态度。
对田纳西州谢尔比县所有内科门诊实践(n = 51)和儿科门诊实践(n = 24)的随机选择的医生代表进行传真和邮件调查。使用李克特量表获得关于采用电子病历障碍的八种医生态度的得分。
调查回复率为55%,其中18%报告当前使用电子病历。这相当于谢尔比县电子病历的普及率为20%。当前使用者比非使用者更不太可能(P = 0.005)认为电子病历会干扰医患互动,并且更不太可能(P = 0.019)担心电子病历的隐私问题。虽然在其他态度上注意到的差异未达到统计学显著性,但可以看到一种趋势,即电子病历使用者对电子病历可靠性的担忧较少(P = 0.0502)。大型实践采用电子病历的可能性并不比小型实践更高。内科和儿科参与者对所有项目的回答相似。从业年限对医生对这些调查项目的回答没有明显影响。
在田纳西州西部的医生群体中,电子病历使用者和非使用者在对医患互动和患者隐私的影响方面态度明显不同。如果能够解决这些问题,使考虑在实践中采用电子病历的医生感到满意,采用率可能会提高。