Department of Business Management, School of Business Administration, Southwestern University of Finance and Economics, Chengdu, P.R. China.
Center for Healthcare Management, Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Am Med Inform Assoc. 2021 Apr 23;28(5):915-922. doi: 10.1093/jamia/ocab034.
Few studies examine physicians' use of different features of health information technology (HIT) in relation to their psychological empowerment and stress, especially in China, where many hospitals are being pushed to share digitized medical information. Further, there are mixed findings about the impact of HIT on stress, with some studies suggesting that HIT increases stress and others suggesting no effect. Hence, there is a need for a nuanced view of HITs to incorporate different features, regions, and outcomes. This work seeks to extend the existing body of knowledge on HIT by assessing the effects of basic (data-related) and advanced (clinical) HIT features on physician empowerment, stress, and ultimately, job satisfaction in Chinese hospitals.
We surveyed 367 physicians at 5 class 3 hospitals (ie, regional hospitals that provide specialist medical and healthcare services and carry out high levels of teaching and scientific research tasks) in 5 provinces in China. We specified and estimated a structural equation model using partial least squares.
Physicians who used advanced features experienced improvement in all dimensions of physician empowerment and significant reduction in stress. Physicians who used basic technology, however, experienced improvement in fewer dimensions of physician empowerment and no significant change in stress. Except for efficacy, all dimensions of physician empowerment and stress predicted job satisfaction.
Healthcare professionals should assess the purpose of HIT features and expect different effects on intermediate and ultimate outcomes. The nuanced view of HIT features and processes leading to outcomes sheds light on their differential effects and resolves inconsistencies in prior findings on HIT effects.
很少有研究考察医生在使用不同健康信息技术（HIT）功能方面与心理授权和压力之间的关系，尤其是在中国，许多医院都在被推动共享数字化医疗信息。此外，关于 HIT 对压力的影响存在混合的研究结果，一些研究表明 HIT 会增加压力，而另一些研究则表明没有影响。因此，需要对 HIT 进行细致的观察，纳入不同的功能、地区和结果。这项工作旨在通过评估基本（与数据相关）和高级（临床）HIT 功能对中国医院医生授权、压力，最终对工作满意度的影响，来扩展现有的 HIT 知识库。
我们对中国 5 个省的 5 家 3 级医院（即提供专科医疗保健服务并开展高水平教学和科研任务的区域医院）的 367 名医生进行了调查。我们使用偏最小二乘法指定并估计了结构方程模型。
使用高级功能的医生在医生授权的所有维度上都有所改善，压力显著降低。然而，使用基本技术的医生在医生授权的维度上的改善较少，压力没有显著变化。除了功效外，医生授权的所有维度和压力都预测了工作满意度。
医疗保健专业人员应评估 HIT 功能的目的，并期望对中间和最终结果产生不同的影响。对 HIT 功能和导致结果的过程的细致观察揭示了它们对不同影响的作用，并解决了先前关于 HIT 影响的发现中的不一致性。
