Hellström Lina, Waern Karolina, Montelius Emelie, Astrand Bengt, Rydberg Tony, Petersson Göran
eHealth Institute, School of Human Sciences, University of Kalmar, Kalmar, Sweden.
BMC Med Inform Decis Mak. 2009 Aug 7;9:37. doi: 10.1186/1472-6947-9-37.
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.
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.
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.
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.
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。
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。
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。
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。