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医生对电子处方的态度——瑞典全面实施情况评估

Physicians' attitudes towards ePrescribing--evaluation of a Swedish full-scale implementation.

作者信息

Hellström Lina, Waern Karolina, Montelius Emelie, Astrand Bengt, Rydberg Tony, Petersson Göran

机构信息

eHealth Institute, School of Human Sciences, University of Kalmar, Kalmar, Sweden.

出版信息

BMC Med Inform Decis Mak. 2009 Aug 7;9:37. doi: 10.1186/1472-6947-9-37.

Abstract

BACKGROUND

The penetration rate of Electronic Health Record (EHR) systems in health care is increasing. However, many different EHR-systems are used with varying ePrescription designs and functionalities. The aim of the present study was to evaluate experienced ePrescribers' attitudes towards ePrescribing for suggesting improvements.

METHODS

Physicians (n = 431) from seven out of the 21 Swedish health care regions, using one of the six most widely implemented EHR-systems with integrated electronic prescribing modules, were recruited from primary care centers and hospital clinics of internal medicine, orthopaedics and surgery. The physicians received a web survey that comprised eight questions on background data and 19 items covering attitudes towards ePrescribing. Forty-two percent (n = 199) of the physicians answered the questionnaire; 90% (n = 180) of the respondents met the inclusion criteria and were included in the final analysis.

RESULTS

A majority of the respondents regarded their EHR-system easy to use in general (81%), and for the prescribing of drugs (88%). Most respondents believed they were able to provide the patients better service by ePrescribing (92%), and regarded ePrescriptions to be time saving (91%) and to be safer (83%), compared to handwritten prescriptions. Some of the most frequently reported weaknesses were: not clearly displayed price of drugs (43%), complicated drug choice (21%), and the perception that it was possible to handle more than one patient at a time when ePrescribing (13%). Moreover, 62% reported a lack of receipt from the pharmacy after successful transmission of an ePrescription. Although a majority (73%) of the physicians reported that they were always or often checking the ePrescription a last time before transmitting, 25% declared that they were seldom or never doing a last check. The respondents suggested a number of improvements, among others, to simplify the drug choice and the cancellation of ePrescriptions.

CONCLUSION

The Swedish physicians in the group studied were generally satisfied with their specific EHR-system and with ePrescribing as such. However, identified weaknesses warrant improvements of the EHR-systems as well as of their implementation in the individual health care organisation.

摘要

背景

电子健康记录(EHR)系统在医疗保健领域的普及率正在上升。然而,许多不同的EHR系统被使用,其电子处方设计和功能各不相同。本研究的目的是评估经验丰富的电子开方者对电子开方的态度,以提出改进建议。

方法

从瑞典21个医疗保健地区中的7个地区招募医生(n = 431),他们使用六种应用最广泛的带有集成电子处方模块的EHR系统之一,这些医生来自初级保健中心以及内科、骨科和外科的医院诊所。医生们收到一份网络调查问卷,其中包括八个关于背景数据的问题和19个涵盖对电子开方态度的项目。42%(n = 199)的医生回答了问卷;90%(n = 180)的受访者符合纳入标准并被纳入最终分析。

结果

大多数受访者认为他们的EHR系统总体上易于使用(81%),用于开药方面也易于使用(88%)。大多数受访者认为通过电子开方能够为患者提供更好的服务(92%),并且认为与手写处方相比,电子处方节省时间(91%)且更安全(83%)。一些最常被报告的弱点包括:药品价格显示不清晰(43%)、药品选择复杂(21%)以及认为电子开方时可以同时处理多个患者(13%)。此外,62%的人报告在成功传输电子处方后未收到药房的回执。尽管大多数(73%)医生报告说他们在传输前总是或经常最后检查电子处方,但25%的人宣称他们很少或从不进行最后检查。受访者提出了一些改进建议,其中包括简化药品选择和取消电子处方。

结论

本研究中的瑞典医生总体上对他们特定的EHR系统以及电子开方本身感到满意。然而,所发现的弱点需要对EHR系统及其在各个医疗保健机构中的实施进行改进。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f102/2732618/bf274d7b4f4f/1472-6947-9-37-1.jpg

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