Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
BMC Med Inform Decis Mak. 2022 Mar 22;22(1):71. doi: 10.1186/s12911-022-01800-1.
Understanding the hospital EHR success rate has great benefits for hospitals. The present study aimed to 1-Propose an extended-ISSM framework and a questionnaire in a systematic manner for EHR evaluation based on nurses' perspectives, 2-Determine the EHR success rate, and 3-Explore the effective factors contributing to EHR success.
The proposed framework was developed using ISSM, TAM3, TTF, HOT-FIT, and literature review in seven steps. A self-administrated structured 65-items questionnaire was developed with CVI: 90.27% and CVR: 94.34%. Construct validity was conducted using EFA and CFA. Eleven factors were identified, collectively accounting for 71.4% of the total variance. In the EFA step, 15 questions and two questions in EFA were excluded. Finally, 48 items remained in the framework including dimensions of technology, human, organization, ease of use, usefulness, and net benefits. The overall Cronbach's alpha value was 93.4%. In addition, the hospital EHR success rate was determined and categorized. In addition, effective factors on EHR success were explored.
In total, 86 nurses participated in the study. On average, the "total hospital EHR success rate" was moderate. The total EHR success rates was ranging from 47.09 to 74.96%. The results of the Kruskal-Wallis test showed that there was a significant relationship between "gender" and "self-efficacy" (p-value: 0.042). A reverse relation between "years of experience using computers" and "training" (p-value: 0.012) was observed. "Years of experience using EHR" as well as "education level" (p-value: 0.001) and "ease of use" had a reverse relationship (p-value: 0.034).
Our findings underscore the EHR success based on nurses' viewpoint in a developing country. Our results provide an instrument for comparison of EHR success rates in various hospitals.
了解医院电子健康记录（EHR）的成功率对医院有很大的好处。本研究旨在：1. 系统地提出一个扩展的信息系统成功模型（ISSM）框架和问卷，用于基于护士视角的 EHR 评估；2. 确定 EHR 的成功率；3. 探索有助于 EHR 成功的有效因素。
该框架是使用 ISSM、TAM3、TTF、HOT-FIT 和文献综述，通过七个步骤开发的。开发了一份自我管理的结构化 65 项问卷，内容效度指数（CVI）为 90.27%，内容效度比（CVR）为 94.34%。使用 EFA 和 CFA 进行结构有效性验证。确定了 11 个因素，共同解释了总方差的 71.4%。在 EFA 步骤中，排除了 15 个问题和 EFA 中的 2 个问题。最后，框架中包含了 48 个项目，涵盖了技术、人员、组织、易用性、有用性和净收益等维度。总体 Cronbach's alpha 值为 93.4%。此外，还确定了医院 EHR 的成功率并进行了分类。此外，还探讨了影响 EHR 成功的有效因素。
共有 86 名护士参与了研究。平均而言，“医院整体 EHR 成功率”处于中等水平。EHR 总成功率在 47.09%至 74.96%之间。Kruskal-Wallis 检验的结果表明，“性别”和“自我效能感”之间存在显著关系（p 值：0.042）。“使用计算机的年限”和“培训”之间呈负相关（p 值：0.012）。“使用 EHR 的年限”以及“教育水平”（p 值：0.001）和“易用性”之间呈负相关（p 值：0.034）。
本研究结果强调了发展中国家基于护士视角的 EHR 成功。我们的研究结果为比较不同医院的 EHR 成功率提供了一个工具。
