Institute of Medical Sociology Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany.
Center for Health Economics and Health Services Research, University of Wuppertal, Wuppertal, Germany.
BMC Health Serv Res. 2021 Apr 23;21(1):377. doi: 10.1186/s12913-021-06377-5.
The need for and usage of electronic patient records within hospitals has steadily increased over the last decade for economic reasons as well as the proceeding digitalization. While there are numerous benefits from this system, the potential risks of using electronic patient records for hospitals, patients and healthcare professionals must also be discussed. There is a lack in research, particularly regarding effects on healthcare professionals and their daily work in health services. The study eCoCo aims to gain insight into changes in interprofessional collaboration and clinical workflows resulting from introducing electronic patient records.
eCoCo is a multi-center case study integrating mixed methods from qualitative and quantitative social research. The case studies include three hospitals that undergo the process of introducing electronic patient records. Data are collected before and after the introduction of electronic patient records using participant observation, interviews, focus groups, time measurement, patient and employee questionnaires and a questionnaire to measure the level of digitalization. Furthermore, documents (patient records) as well as structural and administrative data are gathered. To analyze the interprofessional collaboration qualitative network analyses, reconstructive-hermeneutic analyses and document analyses are conducted. The workflow analyses, patient and employee assessment analyses and classification within the clinical adoption meta-model are conducted to provide insights into clinical workflows.
This study will be the first to investigate the effects of introducing electronic patient records on interprofessional collaboration and clinical workflows from the perspective of healthcare professionals. Thereby, it will consider patients' safety, legal and ethical concerns and quality of care. The results will help to understand the organization and thereby improve the performance of health services working with electronic patient records.
The study was registered at the German clinical trials register (DRKS00023343, Pre-Results) on November 17, 2020.
由于经济原因和数字化进程，过去十年中，医院对电子患者记录的需求和使用稳步增加。虽然该系统有许多好处，但也必须讨论使用电子患者记录给医院、患者和医疗保健专业人员带来的潜在风险。针对该主题的研究相对较少，特别是关于对医疗保健专业人员及其在医疗服务中的日常工作的影响。eCoCo 研究旨在深入了解引入电子患者记录后导致的跨专业协作和临床工作流程的变化。
eCoCo 是一项多中心案例研究，整合了定性和定量社会研究的混合方法。这些案例研究包括三个正在经历引入电子患者记录过程的医院。在引入电子患者记录之前和之后，使用参与式观察、访谈、焦点小组、时间测量、患者和员工问卷调查以及衡量数字化水平的问卷来收集数据。此外，还收集了文件（患者记录）以及结构和行政数据。为了分析跨专业协作，进行了定性网络分析、重构解释学分析和文件分析。为了深入了解临床工作流程，进行了工作流程分析、患者和员工评估分析以及临床采用元模型内的分类。
这项研究将首次从医疗保健专业人员的角度调查引入电子患者记录对跨专业协作和临床工作流程的影响。这样可以考虑到患者的安全、法律和伦理问题以及护理质量。研究结果将有助于了解组织情况，从而提高使用电子患者记录的医疗服务绩效。
该研究于 2020 年 11 月 17 日在德国临床试验注册处（DRKS00023343，预结果）注册。
