Samoutis George, Soteriades Elpidoforos S, Kounalakis Dimitris K, Zachariadou Theodora, Philalithis Anastasios, Lionis Christos
Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
Inform Prim Care. 2007;15(4):207-16. doi: 10.14236/jhi.v15i4.660.
The computer-based electronic medical record (EMR) is an essential new technology in health care, contributing to high-quality patient care and efficient patient management. The majority of southern European countries, however, have not yet implemented universal EMR systems and many efforts are still ongoing. We describe the development of an EMR system and its pilot implementation and evaluation in two previously computer-naïve public primary care centres in Cyprus.
One urban and one rural primary care centre along with their personnel (physicians and nurses) were selected to participate. Both qualitative and quantitative evaluation tools were used during the implementation phase. Qualitative data analysis was based on the framework approach, whereas quantitative assessment was based on a nine-item questionnaire and EMR usage parameters.
Two public primary care centres participated, and a total often health professionals served as EMR system evaluators. Physicians and nurses rated EMR relatively highly, while patients were the most enthusiastic supporters for the new information system. Major implementation impediments were the physicians' perceptions that EMR usage negatively affected their workflow, physicians' legal concerns, lack of incentives, system breakdowns, software design problems, transition difficulties and lack of familiarity with electronic equipment.
The importance of combining qualitative and quantitative evaluation tools is highlighted. More efforts are needed for the universal adoption and routine use of EMR in the primary care system of Cyprus as several barriers to adoption exist; however, none is insurmountable. Computerised systems could improve efficiency and quality of care in Cyprus, benefiting the entire population.
基于计算机的电子病历（EMR）是医疗保健领域一项重要的新技术，有助于提供高质量的患者护理和高效的患者管理。然而，大多数南欧国家尚未实施通用的电子病历系统，许多工作仍在进行中。我们描述了一个电子病历系统的开发及其在塞浦路斯两个以前未使用过计算机的公立基层医疗中心的试点实施和评估情况。
选择一个城市和一个农村基层医疗中心及其工作人员（医生和护士）参与。在实施阶段使用了定性和定量评估工具。定性数据分析基于框架方法，而定量评估基于一份包含九个项目的问卷和电子病历使用参数。
两个公立基层医疗中心参与其中，共有十名卫生专业人员担任电子病历系统评估员。医生和护士对电子病历的评价相对较高，而患者是新信息系统最热情的支持者。主要的实施障碍包括医生认为使用电子病历会对其工作流程产生负面影响、医生的法律担忧、缺乏激励措施、系统故障、软件设计问题、过渡困难以及对电子设备不熟悉。
强调了结合定性和定量评估工具的重要性。由于存在若干采用障碍，塞浦路斯基层医疗系统在普遍采用和常规使用电子病历方面还需要做出更多努力；然而，没有一个障碍是无法克服的。计算机化系统可以提高塞浦路斯的医疗效率和质量，使全体民众受益。
