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[魁北克初级医疗保健提供者采用电子个人健康记录(ePHR)的影响因素:专业和组织视角]

[Factors influencing electronic personal health record (ePHR) adoption by Primary Health Care providers in Quebec: Professional and organizational perspective].

作者信息

Ghandour El Kebir, Gagnon Marie-Pierre, Fortin Jean-Paul

出版信息

Sante Publique. 2017 Nov-Dec;29(6):837-850. doi: 10.3917/spub.176.0837.

Abstract

INTRODUCTION

We aimed to describe and analyse the factors and conditions influencing ePHR adoption by primary healthcare professionals for the follow-up and management of chronic diseases, as perceived by healthcare professionals and health organization managers.

METHODS

A qualitative study was conducted in the context of an ePHR experimentation project in Quebec. In-depth semi-structured individual interviews were conducted with 11 professionals and three managers directly involved in ePHR implementation in a primary healthcare organization.

RESULTS

The results highlight the emergence of themes comprising facilitators or barriers to ePHR adoption. The main factors identified were the clinicians' leadership and previous involvement in organizational transformations, the context of practice, technology maturity providing a useful, additional and relevant content, integration with the available clinical information systems facilitating two-way communication and supporting the development of patient-professional partnerships and patients' use and adherence. The organizational precursors identified refer to the organizational receptivity to change, adjustment to participants' values, and the policies and practices set up to support ePHR adoption by professionals and their patients. Cost is a major issue determining ePHR implementation.

CONCLUSION

The factors and conditions identified will be useful strategically and operationally to design and implement new clinical and organizational practices and develop adapted technologies facilitating ePHR adoption by professionals.

摘要

引言

我们旨在描述和分析医疗保健专业人员和卫生组织管理人员所认为的影响基层医疗保健专业人员采用电子个人健康记录(ePHR)进行慢性病随访和管理的因素及条件。

方法

在魁北克的一个ePHR实验项目背景下开展了一项定性研究。对一家基层医疗保健机构中直接参与ePHR实施的11名专业人员和3名管理人员进行了深入的半结构化个人访谈。

结果

结果突出了构成ePHR采用促进因素或障碍的主题的出现。确定的主要因素包括临床医生的领导力以及先前参与组织变革的经历、实践背景、技术成熟度(提供有用、额外且相关的内容)、与现有临床信息系统的整合(促进双向沟通并支持患者 - 专业人员伙伴关系的发展以及患者的使用和依从性)。确定的组织先兆涉及组织对变革的接受度、对参与者价值观的调整以及为支持专业人员及其患者采用ePHR而制定的政策和实践。成本是决定ePHR实施的一个主要问题。

结论

所确定的因素和条件在战略和运营方面将有助于设计和实施新的临床和组织实践,并开发适配的技术,以促进专业人员采用ePHR。

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