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牙科诊所环境下电子健康记录系统实施的关键成功因素认知:组织管理视角

Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective.

作者信息

Sidek Yusof Haji, Martins Jorge Tiago

机构信息

The University of Sheffield, Information School, United Kingdom.

The University of Sheffield, Information School Regent Court, 211 Portobello Street, S1 4DP Sheffield, United Kingdom.

出版信息

Int J Med Inform. 2017 Nov;107:88-100. doi: 10.1016/j.ijmedinf.2017.08.007. Epub 2017 Sep 1.

Abstract

BACKGROUND

Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics.

OBJECTIVES

This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context.

METHODS

We used Grounded Theory to analyse data collected in the context of Brunei's national EHR - the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding.

RESULTS

Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives.

DISCUSSION

Workflow changes were significant challenges to clinicians' confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment.

摘要

背景

电子健康记录(EHR)提高了医疗保健效率。它们通过使患者病史更易获取来提高医疗质量。然而,对于牙科诊所成功实施电子健康记录的影响因素知之甚少。

目的

本文旨在确定在牙科诊所环境中电子健康记录系统实施的关键成功因素。

方法

我们运用扎根理论分析在文莱国家电子健康记录——医疗保健信息与管理系统(Bru-HIMS)背景下收集的数据。数据分析遵循开放编码、轴心编码和选择编码阶段。

结果

出现了六个关键成功因素:系统可用性、突发行为、需求分析、培训、变革管理和项目组织。该研究发现终端用户与产品所有者/供应商观点之间存在不匹配。

讨论

工作流程的改变是临床医生自信使用该系统的重大挑战,尤其是因为该系统的模块化和可配置性有限。建议参与医疗保健信息系统实施的所有各方通过更广泛的协商性辩论商定系统目标和功能,并通过共同承诺实施支持策略来管理变革过程。

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