McMaster University, Hamilton, Ontario, Canada (R.B.H., A.I.).
University of Utah, Salt Lake City, Utah (G.D.).
Ann Intern Med. 2020 Jun 2;172(11 Suppl):S73-S78. doi: 10.7326/M19-0874.
Electronic health records (EHRs) are ubiquitous yet still evolving, resulting in a moving target for determining the effects of context (features of the work environment, such as organization, payment systems, user training, and roles) on EHR implementation projects. Electronic health records have become instrumental in effecting quality improvement innovations and providing data to evaluate them. However, reports of studies typically fail to provide adequate descriptions of contextual details to permit readers to apply the findings. As for any evaluation, the quality of reporting is essential to learning from, and disseminating, the results. Extensive guidelines exist for reporting of virtually all types of applied health research, but they are not tailored to capture some contextual factors that may affect the outcomes of EHR implementations, such as attitudes toward implementation, format and amount of training, post go-live support, amount of local customization, and time diverted from direct interaction with patients to computers. Nevertheless, evaluators of EHR-based innovations can choose reporting guidelines that match the general purpose of their evaluation and the stage of their investigation (planning, protocol, execution, and analysis) and should report relevant contextual details (including, if pertinent, any pressures to help justify the huge investments and many years required for some implementations). Reporting guidelines are based on the scientific principles and practices that underlie sound research and should be consulted from the earliest stages of planning evaluations and onward, serving as guides for how evaluations should be conducted as well as reported.
电子健康记录（EHRs）无处不在，但仍在不断发展，这使得确定环境（工作环境的特征，如组织、支付系统、用户培训和角色）对 EHR 实施项目的影响成为一个不断变化的目标。电子健康记录在推动质量改进创新和提供数据以评估这些创新方面发挥了重要作用。然而，研究报告通常未能充分描述背景细节，使得读者无法应用研究结果。对于任何评估，报告的质量对于从结果中学习和传播至关重要。几乎所有类型的应用健康研究都有广泛的报告指南，但它们并没有针对可能影响 EHR 实施结果的某些背景因素进行定制，例如对实施的态度、培训的形式和数量、上线后支持、本地定制的程度以及从与患者的直接交互转移到计算机的时间。然而，基于 EHR 的创新的评估人员可以选择符合其评估的一般目的和调查阶段（规划、方案、执行和分析）的报告指南，并应报告相关的背景细节（包括，如果相关，任何帮助证明某些实施需要巨额投资和多年时间的压力）。报告指南基于构成可靠研究基础的科学原则和实践，应在规划评估的最早阶段咨询这些指南，并在整个评估过程中作为指导，说明应如何进行和报告评估。
