Terry Amanda L, Stewart Moira, Fortin Martin, Wong Sabrina T, Kennedy Maureen, Burge Fred, Birtwhistle Richard, Grava-Gubins Inese, Webster Greg, Thind Amardeep
Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.
Inform Prim Care. 2012;20(4):233-40. doi: 10.14236/jhi.v20i4.2.
Major initiatives are underway in Canada which are designed to increase electronic medical record (EMR) implementation and maximise its use in primary health care. These developments need to be supported by sufficient evidence from the literature, particularly relevant research conducted in the Canadian context.
This study sought to quantify this lack of research by: (1) identifying and describing the primary health care EMR literature; and (2) comparing the Canadian and international primary healthcare EMR literature on the basis of content and publication levels.
Seven bibliographic databases were searched using primary health care and EMR keywords. Publication abstracts were reviewed and categorised. First author affiliation was used to identify country of origin. Proportions of Canadian- and non-Canadian-authored publications were compared using Fisher's exact test. For countries having 10 or more primary healthcare EMR publications, publications per 10 000 researchers were calculated.
After exclusions, 750 publications were identified. More than one-third used primary healthcare EMRs as a study data source. Twenty-two (3%) were Canadian-authored. There were significantly different publication levels in three categories between Canadian- and non-Canadian-authored publications. Based on publications per researchers, the Netherlands ranked first, while Canada ranked eighth of nine countries with 10 or more publications.
A relatively small body of literature focused on EMRs in primary health care exists; publications by Canadian authors were low. This study highlights the need to develop a strong evidence base to support the effective implementation and use of EMRs in Canadian primary health care.
加拿大正在开展重大举措，旨在提高电子病历（EMR）的实施率，并在初级卫生保健中最大限度地利用电子病历。这些进展需要有文献中的充分证据支持，特别是在加拿大背景下进行的相关研究。
本研究试图通过以下方式量化这种研究不足的情况：（1）识别和描述初级卫生保健电子病历文献；（2）在内容和发表水平的基础上比较加拿大和国际初级卫生保健电子病历文献。
使用初级卫生保健和电子病历关键词搜索了七个书目数据库。对发表摘要进行了审查和分类。第一作者所属机构用于确定原产国。使用费舍尔精确检验比较加拿大和非加拿大作者发表的文献比例。对于有10篇或更多初级卫生保健电子病历出版物的国家，计算每10000名研究人员的出版物数量。
排除后，共识别出750篇出版物。超过三分之一的研究将初级卫生保健电子病历用作研究数据源。22篇（3%）是加拿大作者撰写的。加拿大和非加拿大作者发表的文献在三个类别中的发表水平存在显著差异。根据每研究人员的出版物数量，荷兰排名第一，而加拿大在有10篇或更多出版物的九个国家中排名第八。
关于初级卫生保健中电子病历的文献相对较少；加拿大作者的出版物数量较低。本研究强调需要建立一个强大的证据基础，以支持加拿大初级卫生保健中电子病历的有效实施和使用。
