Simon Jodi S, Rundall Thomas G, Shortell Stephen M
School of Public Health, University of California at Berkeley, USA.
Jt Comm J Qual Patient Saf. 2005 Nov;31(11):631-9. doi: 10.1016/s1553-7250(05)31081-6.
Use of electronic medical records (EMRs) in health care organizations can reduce medical errors and improve quality of care through physicians' increased use of evidence-based patient care processes. However, only 20%-25% of physician organizations have adopted EMRs. A study was undertaken to determine the characteristics of primary care medical groups that distinguish EMR adopter from nonadopter organizations.
A quantitative nationwide survey was undertaken of all primary care medical groups in the United States with 20 or more physicians; data were collected on 738 medical groups (70% response rate).
Fewer than one-third of the medical groups reported having either patients' medical records or progress notes in an EMR. Large organizations with relatively fewer practice locations were more likely to adopt an EMR.
Large medical groups are more likely to have the financial and human resources necessary to overcome barriers to the adoption of an EMR. Knowing the influence of the other organizational characteristics on EMR adoption will help prepare organizational leaders for the complicated process of achieving consensus among physicians and others in medical groups on the expenditure of funds and other resources to acquire an EMR. Financial incentives for all medical groups will help drive EMR adoption, but financial and technical assistance aimed specifically at smaller groups is particularly warranted. Widespread adoption of EMR among medical groups will take time.
医疗机构使用电子病历（EMR）可通过医生更多地采用循证患者护理流程来减少医疗差错并提高护理质量。然而，只有20%-25%的医生组织采用了电子病历。开展了一项研究以确定区分采用电子病历的基层医疗团体与未采用者的特征。
对美国所有拥有20名或更多医生的基层医疗团体进行了一项全国性定量调查；收集了738个医疗团体的数据（回复率为70%）。
不到三分之一的医疗团体报告称在电子病历中有患者的病历或病程记录。诊所地点相对较少的大型组织更有可能采用电子病历。
大型医疗团体更有可能拥有克服采用电子病历障碍所需的资金和人力资源。了解其他组织特征对采用电子病历的影响将有助于医疗团体的组织领导者为在医生和其他人员之间就花费资金及其他资源获取电子病历达成共识这一复杂过程做好准备。对所有医疗团体的经济激励将有助于推动电子病历的采用，但特别针对较小团体的资金和技术援助尤为必要。医疗团体中广泛采用电子病历尚需时日。
