“我们究竟为什么需要电子健康记录?”。奥地利私人执业医生对电子健康记录的接受情况:一项定性研究。

"Why the hell do we need electronic health records?". EHR acceptance among physicians in private practice in Austria: a qualitative study.

作者信息

Hackl W O, Hoerbst A, Ammenwerth E

机构信息

Institute for Health Information Systems, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnoefer Zentrum 1, 6060 Hall in Tirol, Austria.

出版信息

Methods Inf Med. 2011;50(1):53-61. doi: 10.3414/ME10-02-0020. Epub 2010 Nov 8.

Abstract

BACKGROUND

Progress in the medical sciences, together with related technologies, in the past has led to higher specialization and has created a strong need to exchange health information across institutional borders. The concept of electronic health records (EHR) was introduced to fulfill these needs. Remarkably, many EHR introduction projects ran into trouble, not least because they lacked the acceptance of EHR among physicians. Negative emotions, such as anxiety and fear due to a lack of information, may cause change barriers and hamper physicians' acceptance of such projects.

OBJECTIVES

The goal of this study was to gain deeper insight into the negative emotions related to the intended implementation of a mandatory national electronic health record system (called ELGA) in Austria among physicians in private practice.

METHODS

Qualitative, problem-centered interviews were conducted with eight physicians in private practice in the capital region of Tyrol. The methods of qualitative content analysis were used to analyze the data.

RESULTS

Three hundred and twenty-eight passages in the interviews were selected, annotated, and paraphrased. These passages were assigned to 139 different primary categories. Finally, 18 main categories in the form of statements were derived. They were correlated and a theoretical model was formed to explain the genesis of the detected fears and anxiety related to the ELGA project. The results show that the physicians feel uninformed and snubbed. They fear unknown changes, increased costs, as well as workload and surveillance without obtaining any advantages from using electronic health records in their daily practice.

CONCLUSION

Impartial information campaigns that are tailored to the physicians' needs and questions as along with a comprehensive cost-benefit analysis could benefit the physicians' opinion of EHRs.

摘要

背景

过去医学科学及其相关技术的进步导致了更高的专业化,从而产生了跨越机构边界交换健康信息的强烈需求。电子健康记录(EHR)的概念应运而生以满足这些需求。值得注意的是,许多电子健康记录引入项目都遇到了麻烦,尤其是因为它们缺乏医生对电子健康记录的接受度。由于信息不足而产生的焦虑和恐惧等负面情绪可能会造成变革障碍,并阻碍医生接受此类项目。

目的

本研究的目的是更深入地了解奥地利私人执业医生中与强制实施全国性电子健康记录系统(称为ELGA)相关的负面情绪。

方法

对蒂罗尔州首府地区的八名私人执业医生进行了以问题为中心的定性访谈。采用定性内容分析方法对数据进行分析。

结果

访谈中的328段内容被挑选、注释和释义。这些内容被归入139个不同的主要类别。最后,得出了18个陈述形式的主要类别。对它们进行了关联,并形成了一个理论模型来解释与ELGA项目相关的已检测到的恐惧和焦虑的成因。结果表明,医生们感到信息不足且受到冷落。他们担心未知的变化、成本增加以及工作量和监督增加,同时在日常实践中使用电子健康记录却得不到任何好处。

结论

针对医生的需求和问题开展公正的宣传活动,以及进行全面的成本效益分析,可能会改善医生对电子健康记录的看法。

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