R.F., R.N., paramedics, Department of computer science, Norwegian University of Science and Technology (NTNU). Sem Saelands street 9, 7034 Trondheim, Norway.
Department of computer science, Norwegian University of Science and Technology (NTNU), Norway.
Int J Med Inform. 2021 Sep;153:104522. doi: 10.1016/j.ijmedinf.2021.104522. Epub 2021 Jun 8.
Implementation of an electronic health record (EHR) that is fully integrated for clinical information, patient scheduling, and billing can effectively be shared by the entire healthcare community, both for the municipality and hospitals in Central Norway. The role and involvement of healthcare workers (HCW) in the implementation process might affect the standardization process.
This article focuses on the HCW' involvement in the Willow module's standardization and how they will support the adapted systems from Epic's implementation process of the electronic health record.
This is a descriptive 6-month follow-up study, based on observations of 35 directions and building sessions from August to January 2019 in the Willow module. Structured interviews of 20 informants in November were used to cross-check and validate the observations. The analytical approach was conducted in four general contexts: a) traditional, b) practical, c) emotional, and d) analytical, obtained from the contextual-content analysis. This is discussed based on the system theory.
A) Traditional: Epic's normative perspective predominates with a tight agenda, questions that should be answered, focuses on standardization of workflow and concepts and had low degree of discussion and involvement, especially in direction sessions. b) Practical: HCW' involvement in standardization provides a high degree of practicality in the sessions, which is also a rational achievement. c) Emotional: The sessions' expressive and affective achievement is guided by the HCW' engagement in standardization, dependent on knowledge and background. d) Analytic: The HCW' intellectual involvement in the standardization of workflows and concepts will be, to some degree, an agreement of objective terms.
HCW' involvement in standardization will have a supportive function. They will be involved in different contexts and be a part of the end product Willow module, even though Epic controls these.
实施一个完全集成临床信息、患者预约和计费的电子健康记录(EHR)可以有效地在整个医疗社区中共享,无论是对于挪威中部的市政府还是医院。医疗保健工作者(HCW)在实施过程中的角色和参与度可能会影响标准化进程。
本文关注 HCW 在 Willow 模块标准化中的参与情况,以及他们如何支持 Epic 电子健康记录实施过程中所采用的适应系统。
这是一项为期 6 个月的描述性后续研究,基于 2019 年 8 月至 1 月期间对 Willow 模块中的 35 次方向和构建会议的观察。在 11 月,通过对 20 名知情者的结构化访谈,交叉检查和验证观察结果。分析方法分为四个一般语境:a)传统,b)实践,c)情感,和 d)分析,这些语境是从语境内容分析中得出的。这是基于系统理论进行讨论的。
a)传统:Epic 的规范视角占主导地位,议程紧张,提出了需要回答的问题,重点关注工作流程和概念的标准化,讨论和参与度低,尤其是在方向会议中。b)实践:HCW 对标准化的参与为会议提供了高度的实践性,这也是一种理性的成就。c)情感:会议的表达和情感成就受到 HCW 参与标准化的驱动,这取决于他们的知识和背景。d)分析:HCW 在工作流程和概念标准化方面的智力参与将在某种程度上是对客观术语的认可。
HCW 对标准化的参与将具有支持作用。他们将参与到不同的语境中,并成为 Willow 模块最终产品的一部分,尽管 Epic 控制着这一过程。