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医疗保健提供者对电子健康记录采用的准备情况:实施前阶段的横断面研究。

Healthcare providers' readiness for electronic health record adoption: a cross-sectional study during pre-implementation phase.

机构信息

Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia.

出版信息

BMC Health Serv Res. 2022 Mar 2;22(1):282. doi: 10.1186/s12913-022-07688-x.


DOI:10.1186/s12913-022-07688-x
PMID:35232436
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8889777/
Abstract

BACKGROUND: The adoption of an electronic health record (EHR) in the healthcare system has the potential to make healthcare service delivery effective and efficient by providing accurate, up-to-date, and complete information. Despite its great importance, the adoptions of EHR in low-income country settings, like Ethiopia, were lagging and increasingly failed. Assessing the readiness of stakeholders before the actual adoption of EHR is considered the prominent solution to tackle the problem. However, little is known about healthcare providers' EHR readiness in this study setting. Accordingly, this research was conducted aiming at examining healthcare providers' readiness for EHR adoption and associated factors in southwestern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted from September 1 to October 30, 2021. A total of 423 healthcare providers working in public hospitals were selected using a simple random sampling technique. Multivariable logistic regression was fitted to identify determinant factors of overall healthcare providers' readiness after the other covariates were controlled. RESULT: In this study, the overall good readiness level of EHR adoption was 52.8% (n = 204) [95% CI of 47.9% to 56.6%]. Age, computer literacy, computer access at health facilities, attitude towards EHRs, awareness about EHRs, perceived benefit, and perceived technology self-efficacy were significantly associated with the overall health care providers' readiness for the adoption of EHR using a cut point of P-value less than 0.05. CONCLUSION: Around half of the respondents had a good level of overall healthcare providers' readiness for the adoption of EHR which was considered inadequate. This finding implied that a huge effort is required to improve readiness before the actual implementation of EHRs. The finding implied that younger-aged groups were more ready for such technology which in turn implied; the older one needs more concern. Enhancing computer literacy, confidence building to raise self-efficacy of such technology, addressing the issue of computer availability at health facilities, building a positive attitude, awareness campaign of EHR, and recognizing the usefulness of such systems were the necessary measures to improve EHR readiness in this setting. Additionally, further studies are recommended to encompass all types of EHR readiness such as organizational readiness, technology readiness, societal readiness, and so on. Additionally, exploring the healthcare provider opinion with qualitative study and extending the proposed study to other implementation settings are recommended to be addressed by future works.

摘要

背景:在医疗保健系统中采用电子健康记录(EHR)有可能通过提供准确、最新和完整的信息,使医疗服务的提供更加有效和高效。尽管其非常重要,但在埃塞俄比亚等低收入国家,EHR 的采用一直滞后,而且越来越失败。在实际采用 EHR 之前,评估利益相关者的准备情况被认为是解决问题的突出解决方案。然而,在这个研究环境中,人们对医疗保健提供者的 EHR 准备情况知之甚少。因此,这项研究旨在检查埃塞俄比亚西南部医疗保健提供者对 EHR 采用的准备情况和相关因素。

方法:这是一项 2021 年 9 月 1 日至 10 月 30 日进行的基于机构的横断面研究。采用简单随机抽样技术,从公立医院中选择了 423 名医疗保健提供者。在控制其他协变量后,使用多变量逻辑回归来确定总体医疗保健提供者准备情况的决定因素。

结果:在这项研究中,EHR 采用的总体良好准备水平为 52.8%(n=204)[95%置信区间为 47.9%至 56.6%]。年龄、计算机素养、医疗机构的计算机访问、对 EHR 的态度、对 EHR 的认识、感知益处和感知技术自我效能与整体医疗保健提供者对 EHR 采用的准备情况显著相关,使用 P 值小于 0.05 的截断点。

结论:大约一半的受访者对采用 EHR 有良好的总体医疗保健提供者准备水平,这被认为是不够的。这一发现意味着在实际实施 EHR 之前,需要做出巨大努力来提高准备水平。这一发现意味着年龄较小的群体对这种技术的准备程度更高,而年龄较大的群体则需要更多的关注。提高计算机素养、建立信心以提高对这种技术的自我效能、解决医疗机构计算机可用性问题、建立积极态度、开展 EHR 宣传活动以及认识到这种系统的有用性是提高这种环境中 EHR 准备水平的必要措施。此外,建议进行进一步的研究,涵盖组织准备、技术准备、社会准备等所有类型的 EHR 准备情况。此外,建议未来的工作通过定性研究探索医疗保健提供者的意见,并将提出的研究扩展到其他实施环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e98/8889777/64dd452d779b/12913_2022_7688_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e98/8889777/64dd452d779b/12913_2022_7688_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e98/8889777/64dd452d779b/12913_2022_7688_Fig1_HTML.jpg

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本文引用的文献

[1]
An Exploratory Study of the Readiness of Public Healthcare Facilities in Developing Countries to Adopt Health Information Technology (HIT)/e-Health: the Case of Ghana.

J Healthc Inform Res. 2020-1-31

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Glob Health Med. 2020-8-31

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J Multidiscip Healthc. 2020-12-3

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Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content.

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