Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada.
Implement Sci. 2010 Apr 23;5:30. doi: 10.1186/1748-5908-5-30.
The electronic health record (EHR) is an important application of information and communication technologies to the healthcare sector. EHR implementation is expected to produce benefits for patients, professionals, organisations, and the population as a whole. These benefits cannot be achieved without the adoption of EHR by healthcare professionals. Nevertheless, the influence of individual and organisational factors in determining EHR adoption is still unclear. This study aims to assess the unique contribution of individual and organisational factors on EHR adoption in healthcare settings, as well as possible interrelations between these factors.
A prospective study will be conducted. A stratified random sampling method will be used to select 50 healthcare organisations in the Quebec City Health Region (Canada). At the individual level, a sample of 15 to 30 health professionals will be chosen within each organisation depending on its size. A semi-structured questionnaire will be administered to two key informants in each organisation to collect organisational data. A composite adoption score of EHR adoption will be developed based on a Delphi process and will be used as the outcome variable. Twelve to eighteen months after the first contact, depending on the pace of EHR implementation, key informants and clinicians will be contacted once again to monitor the evolution of EHR adoption. A multilevel regression model will be applied to identify the organisational and individual determinants of EHR adoption in clinical settings. Alternative analytical models would be applied if necessary.
The study will assess the contribution of organisational and individual factors, as well as their interactions, to the implementation of EHR in clinical settings.
These results will be very relevant for decision makers and managers who are facing the challenge of implementing EHR in the healthcare system. In addition, this research constitutes a major contribution to the field of knowledge transfer and implementation science.
电子健康记录（EHR）是信息和通信技术在医疗保健领域的重要应用。预计 EHR 的实施将为患者、专业人员、组织以及整个人群带来益处。如果没有医疗保健专业人员采用 EHR，这些益处将无法实现。然而，个人和组织因素对 EHR 采用的影响仍不清楚。本研究旨在评估个人和组织因素对医疗保健环境中 EHR 采用的独特贡献，以及这些因素之间可能存在的相互关系。
将进行一项前瞻性研究。将使用分层随机抽样方法选择魁北克市卫生区（加拿大）的 50 个医疗保健组织。在个人层面上，将根据组织规模，在每个组织中选择 15 至 30 名卫生专业人员作为样本。将在每个组织中选择两名主要信息员，通过半结构化问卷收集组织数据。将根据 Delphi 过程制定 EHR 采用的综合采用评分，并将其用作因变量。首次联系后的 12 至 18 个月，具体取决于 EHR 实施的速度，将再次联系主要信息员和临床医生，以监测 EHR 采用的演变。将应用多层次回归模型来确定临床环境中 EHR 采用的组织和个人决定因素。如果需要，将应用替代分析模型。
该研究将评估组织和个人因素的贡献，以及它们之间的相互作用，对临床环境中 EHR 的实施。
这些结果对于决策者和管理人员来说非常重要，他们面临着在医疗保健系统中实施 EHR 的挑战。此外，这项研究是知识转移和实施科学领域的一项重大贡献。
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