Emani S, Ting D Y, Healey M, Lipsitz S R, Ramelson H, Suric V, Bates D W
Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA, United States.
Massachusetts General Physicians Organization, Massachusetts General Hospital , Boston,MA, United States.
Appl Clin Inform. 2015 Sep 16;6(3):577-90. doi: 10.4338/ACI-2015-04-RA-0043. eCollection 2015.
A core measure of the meaningful use of EHR incentive program is the generation and provision of the clinical summary of the office visit, or the after visit summary (AVS), to patients. However, little research has been conducted on physician perceptions and beliefs about the AVS.
Evaluate physician perceptions and beliefs about the AVS and the effect of the AVS on workload, patient outcomes, and the care the physician delivers.
A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who are participating in the meaningful use EHR incentive program.
Of the 1 795 physicians at both AMCs participating in the incentive program, 853 completed the survey for a response rate of 47.5%. Eighty percent of the respondents reported that the AVS was easy (very easy or quite easy or somewhat easy) to generate and provide to patients. Nonetheless, more than three-fourths of the respondents reported a negative effect of generating and providing the AVS on workload of office staff (78%) and workload of physicians (76%). Primary care physicians had more positive beliefs about the effect of the AVS on patient outcomes than specialists (p<0.001) and also had more positive beliefs about the effect of the AVS on the care they delivered than specialists (p<0.001).
Achieving the core meaningful use measure of generating and providing the AVS was easy for physicians but it did not necessarily translate into positive beliefs about the effect of the AVS on patient outcomes or the care the physician delivered. Physicians also had negative beliefs about the effect of the AVS on workload. To promote positive beliefs among physicians around the AVS, organizations should obtain physician input into the design and implementation of the AVS and develop strategies to mitigate its negative impacts on workload.
电子健康记录（EHR）激励计划的一项核心衡量标准是为患者生成并提供门诊就诊临床总结，即就诊后总结（AVS）。然而，关于医生对AVS的看法和信念的研究却很少。
评估医生对AVS的看法和信念，以及AVS对工作量、患者结局和医生提供的医疗服务的影响。
对东北部两家参与有意义使用EHR激励计划的学术医疗中心（AMC）的医生进行横断面在线调查。
在两家AMC参与激励计划的1795名医生中，853名完成了调查，回复率为47.5%。80%的受访者表示，生成并向患者提供AVS很容易（非常容易、相当容易或有点容易）。尽管如此，超过四分之三的受访者报告称，生成并提供AVS对办公室工作人员的工作量（78%）和医生的工作量（76%）有负面影响。与专科医生相比，初级保健医生对AVS对患者结局的影响有更积极的信念（p<0.001），并且对AVS对他们提供的医疗服务的影响也有比专科医生更积极的信念（p<0.001）。
对医生来说，实现生成并提供AVS这一核心有意义使用衡量标准很容易，但这并不一定转化为对AVS对患者结局或医生提供的医疗服务的影响的积极信念。医生对AVS对工作量的影响也有负面信念。为了在医生中促进对AVS的积极信念，组织应该在AVS的设计和实施中征求医生的意见，并制定策略来减轻其对工作量的负面影响。
