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家庭医疗中电子病历的实施:一项案例研究。

Implementation of an electronic medical record in family practice: a case study.

作者信息

Gagnon Marie-Pierre, Desmartis Marie, Labrecque Michel, Légaré France, Lamothe Lise, Fortin Jean-Paul, Rancourt Jean-François, Duplantie Julie

机构信息

Québec University Hospital Research Centre, Québec City, Canada and Faculty of Nursing, Laval University, Québec City, Canada.

出版信息

Inform Prim Care. 2010;18(1):31-40. doi: 10.14236/jhi.v18i1.751.

Abstract

BACKGROUND

Electronic medical records (EMRs) have the potential to foster a safer, more effective and more efficient healthcare system. However, their implementation in primary care practice remains a challenge.

OBJECTIVE

This study aims at exploring factors that have influenced the successful implementation of an EMR system in a family medicine group (FMG) in the Province of Québec, Canada.

METHODS

A case study approach was selected to get a deep understanding of the phenomenon in its context. The case was chosen on the basis that it was the first FMG in Québec to implement a full EMR used by all clinicians. Fifteen semi-structured interviews were conducted with key informants.

RESULTS

Factors that have influenced the success of the EMR implementation were classified under three broad themes: a project leader who combined the roles of clinical, technology and knowledge champion; an organisation that was open to and supportive of change; and an evidence-based implementation strategy tailored to the local context and adoption pace.

CONCLUSIONS

This study underscores the importance of a champion for successful EMR implementation. It proposes a set of roles and characteristics that could be found in a champion as well as other elements for a successful EMR implementation strategy.

摘要

背景

电子病历(EMR)有潜力促进建立一个更安全、更有效和更高效的医疗保健系统。然而,在初级医疗实践中实施电子病历仍然是一项挑战。

目的

本研究旨在探索影响加拿大魁北克省一个家庭医疗集团(FMG)成功实施电子病历系统的因素。

方法

选择案例研究方法以深入了解该现象在其背景中的情况。选择该案例是因为它是魁北克第一个实施全体临床医生都使用的完整电子病历的家庭医疗集团。对关键信息提供者进行了15次半结构化访谈。

结果

影响电子病历实施成功的因素分为三大主题:一位兼具临床、技术和知识倡导者角色的项目负责人;一个对变革持开放态度并给予支持的组织;以及一个根据当地情况和采用速度量身定制的循证实施策略。

结论

本研究强调了倡导者对于成功实施电子病历的重要性。它提出了倡导者可能具备的一系列角色和特征以及成功实施电子病历策略的其他要素。

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