Lippincott Christine, Foronda Cynthia, Zdanowicz Martin, McCabe Brian E, Ambrosia Todd
Author Affiliations: School of Nursing and Health Studies, University of Miami, Coral Gables (Dr Lippincott, Dr Foronda, Dr Zdanowicz, and Dr McCabe); and Phillips Beth Israel School of Nursing, New York, NY (Dr Ambrosia).
Comput Inform Nurs. 2017 Aug;35(8):385-391. doi: 10.1097/CIN.0000000000000336.
The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P < .001) and were more likely to adopt electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P < .001; Level 6 or 7: odds ratio = 4.02, P < .001). This study suggested a positive relationship between Magnet status and electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.
本研究的目的是检验卓越护理与电子健康记录采用之间的关系。在美国的6582家医院中，4939家符合医疗保险电子健康记录激励计划的条件，6419家符合医疗卫生信息与管理系统协会（HIMSS）分析电子病历采用模型的评估条件。在399家磁石医院中，330家符合医疗保险电子健康记录激励计划的条件，393家符合医疗卫生信息与管理系统协会分析电子病历采用模型的评估条件。有意义使用认证被定义为收到医疗保险电子健康记录激励计划的付款。电子健康记录的采用被定义为在医疗卫生信息与管理系统协会分析电子病历采用模型中达到6级和/或7级。逻辑回归显示，指定为磁石的医院比非磁石医院更有可能证明有意义使用（优势比 = 3.58，P < .001），并且比非磁石医院更有可能采用电子健康记录（仅6级：优势比 = 3.68，P < .001；6级或7级：优势比 = 4.02，P < .001）。本研究表明磁石状态与电子健康记录使用之间存在正相关关系，这涉及因成功采用而获得经济激励。需要继续进行调查，以检验护理质量、电子健康记录使用、财务影响和患者结局之间的关系。
