卫生提供者对电子健康记录采用的准备情况：加纳北部两家医院的横断面研究。
Health providers' readiness for electronic health records adoption: A cross-sectional study of two hospitals in northern Ghana.
机构信息
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Occupational and Environmental Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
出版信息
PLoS One. 2020 Jun 4;15(6):e0231569. doi: 10.1371/journal.pone.0231569. eCollection 2020.
INTRODUCTION
Electronic Health Records are receiving considerable attention as a valuable tool for managing clinical information. Despite the prospects of Electronic Health Records in developing countries, many pre-implementation assessments target organizational, managerial, and infrastructural readiness, but barely include a detailed examination of health provider readiness. Meanwhile, health provider readiness is a critical success factor for electronic health records in settings where the majority of the workforce is less likely to have basic computer skills. We sought to assess the readiness of health providers for electronic health records in Ghana.
MATERIALS AND METHOD
An institutional-based cross-sectional study was conducted among 350 health providers in northern Ghana from June-September 2019. Data were collected using a modified questionnaire on provider readiness. The mean overall readiness was calculated for each respondent. Providers with readiness score below the overall mean score were categorized as not being ready while those at or above the mean score were considered ready. Multiple linear regression was conducted to determine the factors that determine provider readiness.
RESULTS
Two hundred and nine health providers responded to the questionnaire (59.7 response rate). The mean overall readiness was 3.61 (SD = .76), mean core readiness was 3.74 (SD = .80), and mean engagement readiness was 3.47 (SD = .67). Using the average overall readiness score as the cut-off for determining being ready and not ready for electronic health records, overall readiness was 54.9%, core readiness was 67.2%, while engagement readiness was 43.1%. Age, sex, old employees compared to new employees, computer literacy, and knowledge of electronic health records were significant determinants of health providers' readiness to adopt electronic health records.
CONCLUSION
We observed that health providers were marginally ready for electronic health records adoption. While participants might have expressed dissatisfaction with paper-based records and expressed a desire for electronic health records, they expressed fear of the potential impact of computerized records. We proposed a robust informatics curriculum and capacity building workshops for improving provider readiness for electronic health records.
简介
电子健康记录作为管理临床信息的有价值工具受到了广泛关注。尽管电子健康记录在发展中国家前景广阔，但许多实施前评估的目标是组织、管理和基础设施的准备情况，但几乎没有详细检查卫生提供者的准备情况。然而，在大多数员工不太可能具备基本计算机技能的环境中，卫生提供者的准备情况是电子健康记录取得成功的关键因素。我们旨在评估加纳卫生提供者对电子健康记录的准备情况。
材料与方法
2019 年 6 月至 9 月，在加纳北部进行了一项基于机构的横断面研究，调查了 350 名卫生提供者。使用关于提供者准备情况的修改后的问卷收集数据。为每位受访者计算了总体准备情况的平均值。准备情况得分低于总体平均得分的提供者被归类为未准备就绪，而得分等于或高于平均得分的提供者则被认为是准备就绪。进行了多元线性回归分析，以确定决定提供者准备情况的因素。
结果
有 209 名卫生提供者对问卷做出了回应（59.7%的回应率）。总体准备情况的平均值为 3.61（标准差=0.76），核心准备情况的平均值为 3.74（标准差=0.80），参与准备情况的平均值为 3.47（标准差=0.67）。使用总体准备情况平均得分作为确定是否准备好电子健康记录的截止值，总体准备情况为 54.9%，核心准备情况为 67.2%，而参与准备情况为 43.1%。年龄、性别、老员工与新员工相比、计算机素养和电子健康记录知识是卫生提供者准备采用电子健康记录的重要决定因素。
结论
我们观察到卫生提供者对电子健康记录的采用仅处于边缘准备状态。尽管参与者可能对基于纸张的记录表示不满，并表达了对电子健康记录的渴望，但他们对计算机化记录的潜在影响表示担忧。我们提出了一个强大的信息学课程和能力建设研讨会，以提高卫生提供者对电子健康记录的准备情况。
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