电子健康记录在医疗服务提供者协作中的作用：一项定性研究。
The EHR's roles in collaboration between providers: A qualitative study.
作者信息
Chase Dian A, Ash Joan S, Cohen Deborah J, Hall Jennifer, Olson Gary M, Dorr David A
机构信息
Oregon Health & Science University, Portland, OR.
University of California Irvine, Irvine, CA.
出版信息
AMIA Annu Symp Proc. 2014 Nov 14;2014:1718-27. eCollection 2014.
Abstract
OBJECTIVE
Examine how the Electronic Health Record (EHR) and its related systems support or inhibit provider collaboration.
BACKGROUND
Health care systems in the US are simultaneously implementing EHRs and transitioning to more collaborative delivery systems; this study examines the interaction between these two changes.
METHODS
This qualitative study of five US EHR implementations included 49 interviews and over 60 hours of provider observation. We examined the role of the EHR in building relationships, communicating, coordinating, and collaborative decision-making.
RESULTS
The EHR plays four roles in collaboration: a repository, a messenger, an orchestrator, and a monitor. While EHR performance varied, common themes were decreased trust due to poor quality documentation, incomplete communication, potential for increased effectiveness through better coordination, and the emerging role of the EHR in identifying performance gaps.
CONCLUSION
Both organizational and technical innovations are needed if the EHR is to truly support collaborative behaviors.
摘要
目的
研究电子健康记录（EHR）及其相关系统如何支持或阻碍医疗服务提供者之间的协作。
背景
美国的医疗保健系统正在同时实施电子健康记录，并向更具协作性的提供系统过渡；本研究考察这两种变化之间的相互作用。
方法
这项对美国五个电子健康记录实施案例的定性研究包括49次访谈和超过60小时的医疗服务提供者观察。我们考察了电子健康记录在建立关系、沟通、协调和协作决策中的作用。
结果
电子健康记录在协作中发挥四个作用：知识库、信使、协调者和监督者。虽然电子健康记录的性能各不相同，但共同的主题包括由于文档质量差导致信任度下降、沟通不完整、通过更好的协调有可能提高效率，以及电子健康记录在识别绩效差距方面的新作用。
结论
如果电子健康记录要真正支持协作行为，组织和技术创新都必不可少。
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