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三类不同临床工作人员使用电子健康记录的意向及其影响因素

The intention to use an electronic health record and its antecedents among three different categories of clinical staff.

作者信息

Vitari Claudio, Ologeanu-Taddei Roxana

机构信息

IAE Paris 1 Panthéon-Sorbonne (Sorbonne Business School), 8 bis rue de la Croix Jarry, 75013, Paris, France.

Montpellier Research in Management, University of Montpellier, 34090, Montpellier, France.

出版信息

BMC Health Serv Res. 2018 Mar 21;18(1):194. doi: 10.1186/s12913-018-3022-0.

Abstract

BACKGROUND

Like other sectors, the healthcare sector has to deal with the issue of users' acceptance of IT. In healthcare, different factors affecting healthcare professionals' acceptance of software applications have been investigated. Unfortunately, inconsistent results have been found, maybe because the different studies focused on different IT and occupational groups. Consequently, more studies are needed to investigate these implications for recent technology, such as Electronic Health Records (EHR).

METHODS

Given these findings in the existing literature, we pose the following research question: "To what extent do the different categories of clinical staff (physicians, paraprofessionals and administrative personnel) influence the intention to use an EHR and its antecedents?" To answer this research question we develop a research model that we empirically tested via a survey, including the following variables: intention to use, ease of use, usefulness, anxiety, self-efficacy, trust, misfit and data security. Our purpose is to clarify the possible differences existing between different staff categories.

RESULTS

For the entire personnel, all the hypotheses are confirmed: anxiety, self-efficacy, trust influence ease of use; ease of use, misfit, self-efficacy, data security impact usefulness; usefulness and ease of use contribute to intention to use the EHR. They are also all confirmed for physicians, residents, carers and nurses but not for secretaries and assistants. Secretaries' and assistants' perception of the ease of use of EHR does not influence their intention to use it and they could not be influenced by self-efficacy in the development of their perception of the ease of use of EHR.

CONCLUSIONS

These results may be explained by the fact that secretaries, unlike physicians and nurses, have to follow rules and procedures for their work, including working with EHR. They have less professional autonomy than healthcare professionals and no medical responsibility. This result is also in line with previous literature highlighting that administrators are more motivated by the use of IT in healthcare.

摘要

背景

与其他行业一样,医疗保健行业也必须应对用户对信息技术的接受问题。在医疗保健领域,已经对影响医疗保健专业人员接受软件应用程序的不同因素进行了调查。不幸的是,研究结果并不一致,这可能是因为不同的研究关注的是不同的信息技术和职业群体。因此,需要更多的研究来调查这些因素对诸如电子健康记录(EHR)等最新技术的影响。

方法

鉴于现有文献中的这些发现,我们提出以下研究问题:“不同类别的临床工作人员(医生、辅助专业人员和行政人员)在多大程度上影响使用电子健康记录的意愿及其影响因素?”为了回答这个研究问题,我们开发了一个研究模型,并通过一项调查对其进行了实证检验,该调查包括以下变量:使用意愿、易用性、有用性、焦虑、自我效能感、信任、不匹配和数据安全性。我们的目的是阐明不同工作人员类别之间可能存在的差异。

结果

对于全体人员而言,所有假设均得到证实:焦虑、自我效能感、信任影响易用性;易用性、不匹配、自我效能感、数据安全性影响有用性;有用性和易用性有助于使用电子健康记录的意愿。这些假设对医生(resident,此处resident结合语境似应为住院医生)、护理人员、护士也均得到证实,但对秘书和助理则不然。秘书和助理对电子健康记录易用性的认知并不影响他们使用它的意愿,并且在他们对电子健康记录易用性的认知形成过程中,自我效能感对他们没有影响。

结论

这些结果可以这样解释,与医生和护士不同,秘书在工作中必须遵循规则和程序,包括使用电子健康记录。他们的职业自主性比医疗保健专业人员低,且没有医疗责任。这一结果也与之前强调管理人员在医疗保健中使用信息技术的动机更强的文献一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4803/5863455/ae1f33cccc87/12913_2018_3022_Fig1_HTML.jpg

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