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医生执业特点与医生采用电子健康记录的关系。

The relationship between physician practice characteristics and physician adoption of electronic health records.

机构信息

Center for Health Services Research and Patient Safety, School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, USA.

出版信息

Health Care Manage Rev. 2010 Jan-Mar;35(1):55-64. doi: 10.1097/HMR.0b013e3181c3f9ad.

Abstract

BACKGROUND

Health information technologies, such as electronic health records (EHRs), can potentially improve patient safety in our health care system. The potential advantages include increased quality and more efficiency in the care of patients. Adoption of EHRs has been slow despite these advantages and a national call for EHR implementation.

PURPOSES

This article explores factors associated with the adoption of EHR systems using organizational theory to derive hypotheses as to why physicians would adopt EHRs.

METHODOLOGY/APPROACH: : A survey was administered to all office-based physicians in Nebraska and South Dakota using a modified Dillman technique between July and November 2007. The main outcome variable measured physician EHR adoption status at three levels: not planning to use an EHR, planning to use an EHR, and using an EHR. Factors associated with EHR status were analyzed using a multinomial logistic regression.

FINDINGS

Approximately 30% of physicians reported using an EHR in his or her practice. Physicians adopting EHRs were younger and had access to internal health information technologies support. In addition, working in an independent practice decreased the likelihood of physicians using and adopting EHRs.

PRACTICE IMPLICATIONS

This research provides further evidence of the barriers impeding EHR adoption. One such barrier includes the lack of access to internal information technology support staff versus having to outsource for technical support services. From a resource dependency perspective, barriers illustrated by this example may place undue dependencies on physicians if they pursue an EHR system. By addressing these barriers, physicians may be in a better position to adopt EHR system into his or her practice.

摘要

背景

健康信息技术,如电子健康记录(EHR),可以提高我们医疗体系中的患者安全性。其潜在优势包括提高患者护理的质量和效率。尽管有这些优势和国家对 EHR 实施的呼吁,但 EHR 的采用仍然缓慢。

目的

本文使用组织理论探讨了与采用 EHR 系统相关的因素,以推导出医生采用 EHR 的原因假设。

方法/方法:2007 年 7 月至 11 月期间,使用修改后的 Dillman 技术,向内布拉斯加州和南达科他州的所有门诊医生发放了一份调查。主要观察变量是医生在三个层面上的 EHR 采用状况:不打算使用 EHR、计划使用 EHR 和正在使用 EHR。使用多项逻辑回归分析与 EHR 状况相关的因素。

结果

约 30%的医生报告在其诊所中使用 EHR。采用 EHR 的医生更年轻,并且可以获得内部健康信息技术支持。此外,在独立实践中工作会降低医生使用和采用 EHR 的可能性。

实践意义

这项研究进一步证明了阻碍 EHR 采用的障碍。其中一个障碍是缺乏内部信息技术支持人员,而不得不外包技术支持服务。从资源依赖的角度来看,如果医生追求 EHR 系统,这种例子所说明的障碍可能会对他们造成过度依赖。通过解决这些障碍,医生可能更有能力将 EHR 系统引入他们的实践中。

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