Division of Quality and Medical Informatics, Weill Cornell Medical College, New York, NY, USA.
J Eval Clin Pract. 2012 Dec;18(6):1133-9. doi: 10.1111/j.1365-2753.2011.01756.x. Epub 2011 Aug 23.
RATIONALE, AIMS AND OBJECTIVES: Early adopters of electronic health records (EHRs) are transitioning from older to newer EHRs to satisfy meaningful use requirements. Facilitators and barriers to satisfaction after transitioning are important to understand as provider satisfaction is linked with improvement in health care.
We conducted a cross-sectional survey of providers who transitioned from an older to a newer EHR at six academic, urban ambulatory medical practices. A novel survey was developed to assess: (1) satisfaction with the EHR implementation; (2) patterns of information technology use; (3) work perceptions; (4) methods for completing clinical tasks; and (5) demographic characteristics. We analysed the results using bivariate and multivariate analyses.
The response rate was 64% (n = 197). A small majority were satisfied with the new EHR (64%, n = 120). Providers who reported satisfaction with overall quality of work life, their workload and the transition were more likely to be satisfied with the new EHR (P < 0.01). Providers who reported using the Internet at least daily were also more likely to be satisfied with the new EHR (P < 0.05). In a multivariate model, satisfaction with the transition was a strong predictor of satisfaction with the new EHR (P < 0.01). Barriers to satisfaction include dissatisfaction with: maintaining problem and medication lists, tracking health maintenance information, referring to clinical practice guidelines and ordering laboratory and radiology tests (P < 0.01).
This study provides groundwork for understanding the facilitators and barriers to provider satisfaction after the transition between EHRs and provides insight into areas requiring attention by entities undergoing similar transitions.
背景、目的和目标:电子病历(EHR)的早期采用者正在从较旧的 EHR 过渡到较新的 EHR,以满足有意义使用的要求。了解满足过渡要求后的促进因素和障碍非常重要,因为提供者的满意度与改善医疗保健相关。
我们对六家学术性城市门诊医疗实践中从较旧的 EHR 过渡到较新的 EHR 的提供者进行了横断面调查。开发了一项新的调查来评估:(1)对 EHR 实施的满意度;(2)信息技术使用模式;(3)工作认知;(4)完成临床任务的方法;(5)人口统计学特征。我们使用单变量和多变量分析来分析结果。
回复率为 64%(n = 197)。大多数人对新的 EHR 感到满意(64%,n = 120)。报告对工作生活整体质量、工作量和过渡满意的提供者更有可能对新的 EHR 感到满意(P < 0.01)。报告至少每天使用互联网的提供者也更有可能对新的 EHR 感到满意(P < 0.05)。在多变量模型中,对过渡的满意度是对新的 EHR 满意度的强烈预测因素(P < 0.01)。满意度的障碍包括对以下方面的不满:维护问题和药物清单、跟踪健康维护信息、参考临床实践指南以及订购实验室和放射学检查(P < 0.01)。
本研究为了解 EHR 之间过渡后提供者满意度的促进因素和障碍提供了基础,并为正在经历类似过渡的实体提供了需要关注的领域的见解。