Department of Biology, Murray State University, Murray, Kentucky, USA.
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
J Am Med Inform Assoc. 2021 Jul 14;28(7):1543-1547. doi: 10.1093/jamia/ocab044.
Successful technological implementations frequently involve individuals who serve as mediators between end users, management, and technology developers. The goal for this project was to evaluate the structure and activities of such mediators in a large-scale electronic health record implementation.
Field notes from observations taken during implementation beginning in November 2017 were analyzed qualitatively using a thematic analysis framework to examine the relationship between specific types of mediators and the type and level of support to end users.
We found that support personnel possessing both contextual knowledge of the institution's workflow and training in the new technology were the most successful in mediation of adoption and use. Those that lacked context of either technology or institutional workflow often displayed barriers in communication, trust, and active problem solving.
These findings suggest that institutional investment in technology training and explicit programs to foster skills in mediation, including roles for professionals with career development opportunities, prior to implementation can be beneficial in easing the pain of system transition.
成功的技术实施通常涉及充当终端用户、管理层和技术开发人员之间的中介的个人。该项目的目标是评估在大规模电子健康记录实施中此类中介的结构和活动。
对 2017 年 11 月开始实施期间观察到的现场记录进行了定性分析，使用主题分析框架来检查特定类型的中介与向终端用户提供的支持的类型和级别之间的关系。
我们发现，同时具备机构工作流程的上下文知识和新技术培训的支持人员在采用和使用方面的中介最为成功。那些缺乏技术或机构工作流程背景的人往往在沟通、信任和积极解决问题方面存在障碍。
这些发现表明，机构在技术培训方面的投资以及明确的培养中介技能的计划，包括为具有职业发展机会的专业人员提供的角色，在实施前可以有助于缓解系统过渡的痛苦。
