军事卫生系统电子健康记录（武装部队健康纵向技术应用）中工具使用的预测因素

Predictors of tool usage in the military health system's electronic health record, the Armed Forces Health Longitudinal Technology Application.

作者信息

Rockswold Paul D, Finnell Val W

机构信息

Navy and Marine Corps Public Health Center, 620 John Paul Jones Cir., Ste 1100, Portsmouth, VA 23708-2103, USA.

出版信息

Mil Med. 2010 May;175(5):313-6. doi: 10.7205/milmed-d-09-00286.

DOI:10.7205/milmed-d-09-00286

PMID:20486501

Abstract

OBJECTIVE

To assess the association between key predictor variables and use of advanced features for the Armed Forces Health Longitudinal Technology Application (AHLTA), the electronic health record (EHR) for the Military Health System (MHS).

METHODS

Secondary analysis of a web-based volunteer survey of 520 Navy AHLTA users. chi2 and logistic regression methods were used to assess the strength of relationship between three predictor variables and the use of several advanced AHLTA features.

RESULTS

Adequacy of initial training was associated with increased use of the template management module (adjusted OR = 2.34, 95% CI 1.64-3.61) and order sets (adjusted OR = 1.64, 95% CI 1.07-2.51). Duration of AHLTA usage was associated with use of all advanced features (adjusted OR = 1.69-6.12, p < or = 0.001-0.045). Physicians use most of the advanced features more than nonphysicians (adjusted OR = 1.95-7.07, p < or = 0.001-0.030). Seventy percent of users cited a slow screen refresh rate as a problem.

CONCLUSIONS

Training, duration of usage, and provider role are associated with use of advanced features.

摘要

目的

评估关键预测变量与美国武装部队健康纵向技术应用系统（AHLTA，军事卫生系统（MHS）的电子健康记录）高级功能使用之间的关联。

方法

对520名海军AHLTA用户进行的基于网络的自愿调查的二次分析。采用卡方检验和逻辑回归方法评估三个预测变量与AHLTA几个高级功能使用之间的关系强度。

结果

初始培训的充分性与模板管理模块使用增加相关（调整后比值比=2.34，95%置信区间1.64 - 3.61）以及医嘱集使用增加相关（调整后比值比=1.64，95%置信区间1.07 - 2.51）。AHLTA使用时长与所有高级功能的使用相关（调整后比值比=1.69 - 6.12，p≤0.001 - 0.045）。医生比非医生更多地使用大多数高级功能（调整后比值比=1.95 - 7.07，p≤0.001 - 0.