Clarke Arabella, Adamson Joy, Sheard Laura, Cairns Paul, Watt Ian, Wright John
Department of Health Sciences, University of York, York, UK.
Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.
BMC Med Inform Decis Mak. 2015 Oct 14;15:85. doi: 10.1186/s12911-015-0204-0.
Our aim was to explore the approaches to and the challenges and benefits of implementing Electronic Patient Record systems (EPRs) into NHS acute, mental health and community care hospitals throughout England.
A mixed methods approach was adopted that comprised an online survey (n = 59) and semi-structured telephone interviews (n = 8) with chief information officers (or heads of EPR projects) at NHS trusts throughout England. Survey analysis was descriptive, whilst the qualitative interviews were analysed thematically.
A range of devices and approaches to implementing EPRs were described with 32 % of survey respondents utilising a best of breed approach. Interviewees' perceived and expected benefits of implementing an EPR included efficiency, availability and accessibility of clinical information, and patient safety. Key challenges to EPR implementation were securing clinician involvement, difficulties posed by government and national policy and limited availability of financial and human resources.
There was no single approach regarding the approaches taken to implementing EPRs among participating English NHS trusts, with various benefits and challenges cited. Policymakers and researchers need to provide clearer guidance for trusts at various stages of implementation ensuring intelligence is shared across England's NHS trusts.
我们的目的是探索在英格兰国民保健制度（NHS）的急症、心理健康和社区护理医院中实施电子病历系统（EPRs）的方法以及面临的挑战和益处。
采用了混合方法，包括对英格兰各地NHS信托机构的首席信息官（或EPR项目负责人）进行在线调查（n = 59）和半结构化电话访谈（n = 8）。调查分析采用描述性方法，而定性访谈则进行主题分析。
描述了一系列实施EPRs的设备和方法，32%的调查受访者采用了最佳-of-breed方法。受访者认为和期望实施EPR带来的益处包括临床信息的效率、可用性和可及性以及患者安全。EPR实施的主要挑战包括确保临床医生的参与、政府和国家政策带来的困难以及财政和人力资源的有限可用性。
参与的英国NHS信托机构在实施EPRs的方法上没有单一的模式，存在各种益处和挑战。政策制定者和研究人员需要在实施的各个阶段为信托机构提供更清晰的指导，确保在英格兰的NHS信托机构之间共享信息。
