Quinlivan Julie A, Lyons Sarah, Petersen Rodney W
1 Department of Obstetrics and Gynaecology, Joondalup Health Campus , Joondalup, Australia .
Telemed J E Health. 2014 Sep;20(9):810-5. doi: 10.1089/tmj.2013.0342. Epub 2014 Jul 21.
On July 1, 2012 the Australian Government launched the personally controlled electronic health record (PCEHR). This article surveys obstetric patients about their medical record preferences and identifies barriers to adoption of the PCEHR.
A survey study was conducted of antenatal patients attending a large Australian metropolitan hospital. Consecutive patients completed questionnaires during the launch phase of the PCEHR system. Quantitative and qualitative data were collected on demographics, computer access and familiarity, preference for medical record system, and perceived benefits and concerns.
Of 528 women eligible to participate, 474 completed the survey (89.8%). Respondents had high levels of home access to a computer (90.5%) and the Internet (87.1%) and were familiar with using computers in daily life (median Likert scale of 9 out of 10). Despite this, respondents preferred hospital-held paper records, and only one-third preferred a PCEHR; the remainder preferred patient-held records. Compared with hospital-held paper records, respondents felt a PCEHR would reduce the risk of lost records (p<0.0001) and improve staff communication (p<0.0001). However, there were significant concerns about confidentiality and privacy of the PCEHR (p<0.0001) and lack of control (p<0.0001).
Consumers see advantages and disadvantages with the PCEHR, although the majority still prefer existing record systems. To increase uptake, confidentiality, privacy, and control concerns need to be addressed.
2012年7月1日,澳大利亚政府推出了个人控制电子健康记录(PCEHR)。本文对产科患者的病历偏好进行了调查,并确定了采用PCEHR的障碍。
对一家大型澳大利亚都市医院的产前患者进行了一项调查研究。在PCEHR系统启动阶段,连续的患者完成了问卷调查。收集了有关人口统计学、计算机使用情况和熟悉程度、病历系统偏好以及感知到的益处和担忧的定量和定性数据。
在528名符合参与条件的女性中,474人完成了调查(89.8%)。受访者家中拥有计算机的比例很高(90.5%),拥有互联网的比例也很高(87.1%),并且在日常生活中熟悉使用计算机(李克特量表中位数为十分制中的9分)。尽管如此,受访者更喜欢医院保存的纸质病历,只有三分之一的人更喜欢PCEHR;其余的人更喜欢患者自己保存的病历。与医院保存的纸质病历相比,受访者认为PCEHR会降低病历丢失的风险(p<0.0001)并改善工作人员之间的沟通(p<0.0001)。然而,对于PCEHR的保密性和隐私性(p<0.0001)以及缺乏控制权(p<0.0001)存在重大担忧。
消费者认为PCEHR有优点也有缺点,尽管大多数人仍然更喜欢现有的病历系统。为了提高采用率,需要解决对保密性、隐私性和控制权的担忧。