Kimmel Cancer Center and Jefferson School of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA.
J Oncol Pract. 2012 Jul;8(4):219-23. doi: 10.1200/JOP.2011.000382. Epub 2012 Mar 20.
Adoption and meaningful use of electronic health record (EHR) systems is an important national goal. We undertook a pilot study to determine the level of adoption and barriers to implementation of meaningful use (MU) of EHR systems as defined by the Centers for Medicare & Medicaid Services (CMS) in US radiation oncology practices.
We administered a Web-based survey instrument to a convenience sample of 40 departments of radiation oncology. We determined the current status of EHR system use at each facility, attitudes toward EHR systems, knowledge of MU criteria, plans and barriers to implementation, and whether selected interventions would be helpful with regard to compliance with MU criteria.
Twenty-one of 40 radiation oncology facilities completed the survey, for a 53% response rate. Respondents were mostly large academic practices with a median of six (range, one to 32) full-time physicians and 70 (range, eight to 650) patients treated daily. Most facilities (81%) currently used an EHR system. The majority (84%) of facilities were aware of MU criteria, and of these, 67% expected to implement MU-compliant systems by the year 1 reporting deadline of October 1, 2011. The most frequently cited barriers to implementation were high cost, difficulty integrating with hospital systems, and a lack of national guidelines for implementation.
Most large academic radiation oncology practices have already incorporated EHR systems into practice and plan to meet MU requirements. Further work should focus on assessment of needs for smaller practices. Radiation oncology-specific guidelines may improve widespread adoption.
采用并合理使用电子健康记录（EHR）系统是一个重要的国家目标。我们进行了一项试点研究，以确定美国放射肿瘤学实践中医疗保险和医疗补助服务中心（CMS）定义的 EHR 系统的采用程度和实施有意义使用（MU）的障碍。
我们向 40 个放射肿瘤学部门的便利样本发放了基于网络的调查工具。我们确定了每个机构的 EHR 系统使用现状、对 EHR 系统的态度、对 MU 标准的了解、实施计划和障碍，以及针对 MU 标准的合规性，某些干预措施是否会有所帮助。
40 个放射肿瘤学设施中有 21 个完成了调查，回复率为 53%。受访者主要来自大型学术实践，中位数为 6 名（范围为 1 至 32 名）全职医生和 70 名（范围为 8 至 650 名）每天接受治疗的患者。大多数设施（81%）目前使用 EHR 系统。大多数设施（84%）都了解 MU 标准，其中 67%的设施预计将在 2011 年 10 月 1 日的第一年报告截止日期前实施符合 MU 标准的系统。实施过程中最常被引用的障碍是成本高、与医院系统集成困难以及缺乏国家实施指南。
大多数大型学术放射肿瘤学实践已经将 EHR 系统纳入实践，并计划满足 MU 要求。进一步的工作应侧重于评估较小实践的需求。放射肿瘤学专用指南可能会提高广泛采用率。
