Christensen Tom, Grimsmo Anders
Department of Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Medisinsk Teknisk Forskningssenter (MTFS), N-7489 Trondheim, Norway.
Inform Prim Care. 2008;16(1):21-8. doi: 10.14236/jhi.v16i1.671.
Although primary care physicians are satisfied users of electronic patient records (EPRs) in Norway today, EPR systems may not have reached their full potential. We studied primary care physicians' needs and experiences in relation to EPRs and analysed potential improvements for today's EPR systems. RESPONDENTS AND METHODS: This is a triangulated study that compares qualitative and quantitative data from focus groups, observations of primary care encounters and a questionnaire survey.
General practioners (GPs) were not satisfied with the level of availability of information within EPR systems. They were especially concerned about follow-up for chronic disease and dealing with patients with multiple conditions. Many expressed a desire for reminders and easier access to clinical guidelines under normal working conditions, as well as the possibility of consultations with specialists from their EPR systems. GPs placed importance on the ability to communicate electronically with patients.
Progress toward a problem-oriented EPR system based on episodes of care that includes decision support is necessary to satisfy the needs expressed by GPs. Further research could solve the problem of integration of functionality for consultation with specialists and integration with patient held records. Results from this study could contribute to further development of the next generation of EPRs in primary care, as well as inspire the application of EPRs in other parts of the health sector.
尽管如今挪威的基层医疗医生是电子病历(EPR)的满意用户,但EPR系统可能尚未发挥其全部潜力。我们研究了基层医疗医生在EPR方面的需求和经验,并分析了当今EPR系统的潜在改进之处。
这是一项三角互证研究,比较了焦点小组的定性和定量数据、基层医疗问诊观察结果以及问卷调查结果。
全科医生(GP)对EPR系统内信息的可获取程度不满意。他们尤其关注慢性病的随访以及对患有多种疾病的患者的处理。许多人表示希望在正常工作条件下能得到提醒并更便捷地获取临床指南,以及能通过其EPR系统与专科医生进行会诊。全科医生重视与患者进行电子通信的能力。
有必要朝着基于诊疗过程、包含决策支持的面向问题的EPR系统迈进,以满足全科医生表达的需求。进一步的研究可以解决与专科医生会诊功能的整合以及与患者持有的记录整合的问题。本研究结果有助于基层医疗中下一代EPR的进一步发展,并激励EPR在卫生部门其他领域的应用。