Chisolm Deena J, Purnell Tanjala S, Cohen Daniel M, McAlearney Ann Scheck
The Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, OH 43205, USA.
Pediatr Emerg Care. 2010 Feb;26(2):107-10. doi: 10.1097/PEC.0b013e3181ce2f99.
The objectives of this study were to measure clinician perceptions of the recently implemented electronic medical record (EMR) system in a pediatric emergency department and off-site urgent care centers and to determine how user perceptions changed over time.
Physicians and nurses from the emergency department/urgent care center were recruited to complete an online survey at 3 points in time: 30 to 89 days (wave 1), 90 to 179 days (wave 2), and 180 to 270 days after implementation (wave 3). Potential predictors of initial satisfaction studied included effort expectancy, performance expectancy, social support, and facilitating conditions, along with user demographics and general attitudes toward technology. Bivariate relationships with satisfaction were assessed using the Wilcoxon rank sum test and correlation analysis. A final multivariate linear regression model was calculated. Change in satisfaction over time was tested using a Wilcoxon signed rank test.
A total of 71 clinicians completed the surveys. Initial satisfaction was strongly associated with perceptions of training and support (facilitating conditions) and with perceived usefulness (performance expectancy). Satisfaction was not associated with user sex, age, or role (physician vs nurse). No significant change was found in any satisfaction measure at wave 2 or 3; however, satisfaction with functionality trended higher and satisfaction with reliability trended lower over the course of use.
Satisfaction with an EMR at its launch generally persisted through the first year of use. Implementation plans must maximize the likelihood of achieving positive early impressions of training, support, and performance to engender high user satisfaction with the EMR.
本研究的目的是衡量临床医生对儿科急诊科和异地紧急护理中心最近实施的电子病历（EMR）系统的看法，并确定用户看法如何随时间变化。
招募急诊科/紧急护理中心的医生和护士在三个时间点完成在线调查：实施后30至89天（第1波）、90至179天（第2波）和180至270天（第3波）。研究的初始满意度潜在预测因素包括努力期望、绩效期望、社会支持和便利条件，以及用户人口统计学和对技术的总体态度。使用Wilcoxon秩和检验和相关分析评估与满意度的双变量关系。计算最终的多元线性回归模型。使用Wilcoxon符号秩检验测试满意度随时间的变化。
共有71名临床医生完成了调查。初始满意度与培训和支持的看法（便利条件）以及感知有用性（绩效期望）密切相关。满意度与用户性别、年龄或角色（医生与护士）无关。在第2波或第3波中，任何满意度指标均未发现显著变化；然而，在使用过程中，对功能的满意度呈上升趋势，对可靠性的满意度呈下降趋势。
对EMR的初始满意度在使用的第一年通常会持续。实施计划必须最大限度地提高在培训、支持和性能方面获得积极早期印象的可能性，以提高用户对EMR的满意度。
