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有意义使用电子健康记录 7 年后:医生和护士的经验。

Seven years after Meaningful Use: Physicians' and nurses' experiences with electronic health records.

机构信息

Cheryl Rathert, PhD, is Associate Professor, Department of Health Administration, Virginia Commonwealth University, Richmond. E-mail:

出版信息

Health Care Manage Rev. 2019 Jan/Mar;44(1):30-40. doi: 10.1097/HMR.0000000000000168.

Abstract

Although the federal government's Meaningful Use electronic health record (EHR) implementation program resulted in some successes, there have been many challenges. The purpose of this study was to obtain detailed empirical data to better understand physicians' and nurses' experiences with EHRs. We conducted in-depth interviews with 30 physicians and nurses from two large health systems that were focused on attaining Stage 3 Meaningful Use criteria. Thematic framework analysis identified themes related to perceived benefits and challenges with EHR use. Participants appreciated benefits such as real-time patient data and easier access to information. Challenges included lack of interoperability across units, and this seemed to underlie many other noted challenges such as increased workload, insufficient training, and the perceived need for workarounds. Two key findings included mixed messages about trust in the EHR's information and its interference with interpersonal relationships. Results suggest that conservation of resources theory may be a useful strategy for understanding behaviors that enhance or undermine effective EHR use. Implications for policy and practice are discussed.

摘要

虽然联邦政府的有意义使用电子健康记录 (EHR) 实施计划取得了一些成功,但也存在许多挑战。本研究的目的是获得详细的经验数据,以更好地了解医生和护士使用 EHR 的经验。我们对来自两个大型医疗系统的 30 名医生和护士进行了深入访谈,这些医疗系统专注于实现第 3 阶段有意义使用的标准。主题框架分析确定了与使用 EHR 的感知益处和挑战相关的主题。参与者赞赏实时患者数据和更轻松访问信息等好处。挑战包括单位之间缺乏互操作性,这似乎是其他许多注意到的挑战的基础,例如工作量增加、培训不足以及认为需要变通办法。两个关键发现包括对 EHR 信息的信任和其对人际关系的干扰的信息相互矛盾。结果表明,资源保存理论可能是理解增强或破坏有效 EHR 使用的行为的有用策略。讨论了对政策和实践的影响。

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