Department of Family Medicine, The Ohio State University College of Medicine, Columbus, OH, 43201, USA.
The Center for the Advancement of Team Science, Analytics, and Systems Thinking, Columbus, OH, USA.
BMC Med Inform Decis Mak. 2020 Feb 10;20(1):25. doi: 10.1186/s12911-020-1030-6.
Electronic Health Records (EHRs) have the potential to improve many aspects of care and their use has increased in the last decade. Because of this, acceptance and adoption of EHRs is less of a concern than adaptation to use. To understand this issue more deeply, we conducted a qualitative study of physician perspectives on EHR use to identify factors that facilitate adaptation.
We conducted semi-structured interviews with 9 physicians across a range of inpatient disciplines at a large Academic Medical Center. Interviews were conducted by phone, lasting approximately 30 min, and were transcribed verbatim for analysis. We utilized inductive and deductive methods in our analysis.
We identified 4 major themes related to EHR adaptation: impact of EHR changes on physicians, how physicians managed these changes, factors that facilitated adaptation to using the EHR and adapting to using the EHR in the patient encounter. Within these themes, physicians felt that a positive mindset toward change, providing upgrade training that was tailored to their role, and the opportunity to learn from colleagues were important facilitators of adaptation.
As EHR use moves beyond implementation, physicians continue to be required to adapt to the technology and to its frequent changes. Our study provides actionable findings that allow healthcare systems to focus on factors that facilitate the adaptation process for physicians.
电子健康记录 (EHR) 有可能改善护理的许多方面，并且在过去十年中其使用有所增加。因此，EHR 的接受和采用不再像适应使用那样令人担忧。为了更深入地了解这个问题，我们对医生使用 EHR 的观点进行了定性研究，以确定促进适应的因素。
我们在一家大型学术医疗中心对来自不同住院科室的 9 名医生进行了半结构化访谈。访谈通过电话进行，持续约 30 分钟，并逐字转录以供分析。我们在分析中采用了归纳和演绎方法。
我们确定了与 EHR 适应相关的 4 个主要主题：EHR 变化对医生的影响、医生如何管理这些变化、促进适应使用 EHR 的因素以及在患者就诊中适应使用 EHR。在这些主题中，医生认为积极的变革心态、提供针对其角色定制的升级培训以及向同事学习的机会是适应的重要促进因素。
随着 EHR 的使用超越了实施阶段，医生仍然需要适应技术及其频繁的变化。我们的研究提供了可操作的发现，使医疗保健系统能够专注于促进医生适应过程的因素。
