Jones Mavis, Koziel Chad, Larsen Darren, Berry Plumaletta, Kubatka-Willms Elena
OntarioMD, Toronto, ON, Canada.
Formerly with OntarioMD, Toronto, ON, Canada.
JMIR Med Inform. 2017 Feb 22;5(1):e5. doi: 10.2196/medinform.6928.
This paper describes a change management strategy, including a self-assessment survey tool and electronic medical record (EMR) maturity model (EMM), developed to support the adoption and implementation of EMRs among community-based physicians in the province of Ontario, Canada.
The aim of our study was to present an analysis of progress in EMR use in the province of Ontario based on data from surveys completed by over 4000 EMR users.
The EMM and the EMR progress report (EPR) survey tool clarify levels of capability and expected benefits of improved use. Maturity is assessed on a 6-point scale (0-5) for 25 functions, across 7 functional areas, ranging from basic to more advanced. A total of 4214 clinicians completed EPR surveys between April 2013 and March 2016. Univariate and multivariate descriptive statistics were calculated to describe the survey results.
Physicians reported continual improvement over years of use, perceiving that the longer they used their EMR, the better patient care they provided. Those with at least two years of experience reported the greatest progress.
From our analyses at this stage we identified: (1) a direct correlation between years of EMR use and EMR maturity as measured in our model, (2) a similar positive correlation between years of EMR use and the perception that these systems improve clinical care in at least four patient-centered areas, and (3) evidence of ongoing improvement even in advanced years of use. Future analyses will be supplemented by qualitative and quantitative data collected from field staff engagements as part of the new EMR practice enhancement program (EPEP).
本文描述了一种变革管理策略，包括一个自我评估调查工具和电子病历成熟度模型（EMM），该策略旨在支持加拿大安大略省社区医生采用和实施电子病历。
我们研究的目的是根据4000多名电子病历用户完成的调查数据，对安大略省电子病历使用的进展情况进行分析。
电子病历成熟度模型和电子病历进展报告（EPR）调查工具明确了能力水平和改进使用后的预期收益。从基础到更高级的7个功能领域中的25项功能，按照6分制（0 - 5）对成熟度进行评估。2013年4月至2016年3月期间，共有4214名临床医生完成了电子病历进展报告调查。计算单变量和多变量描述性统计数据以描述调查结果。
医生们报告称，在多年的使用过程中持续改进，他们认为使用电子病历的时间越长，提供的患者护理就越好。有至少两年经验的医生报告的进展最大。
从现阶段的分析中我们发现：（1）在我们的模型中，电子病历使用年限与电子病历成熟度之间存在直接关联；（2）电子病历使用年限与认为这些系统在至少四个以患者为中心的领域改善临床护理之间存在类似的正相关；（3）即使在使用多年后仍有持续改进的证据。作为新的电子病历实践强化计划（EPEP）的一部分，未来的分析将通过从现场工作人员参与中收集的定性和定量数据进行补充。
