Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
BMJ Health Care Inform. 2022 May;29(1). doi: 10.1136/bmjhci-2022-100567.
To explore emergency department (ED) and urgent care (UC) clinicians' perceptions of digital access to patients' past medical history (PMH).
An online survey compared anticipated and actual value of access to digital PMH. UTAUT2 (Unified Theory of Acceptance and Use of Technology 2) was used to assess technology acceptance. Quantitative data were analysed using Mann-Whitney U tests and qualitative data were analysed using a general inductive approach.
33 responses were received. 94% (16/17) of respondents with PMH access said they valued their PMH system and all respondents with no digital PMH access (100%; 16/16) said they believed access would be valuable. Both groups indicated a high level of technology acceptance across all UTAUT2 dimensions. Free-text responses suggested improvements such as increasing the number of patient records available, standardisation of information presentation, increased system reliability, expanded access to information and validation by authoritative/trusted sources.
Non-PMH respondents' expectations were closely matched with the benefits obtained by PMH respondents. High levels of technology acceptance indicated a strong willingness to adopt. Clinicians appeared clear about the improvements they would like for PMH content and access. Policy implications include the need to focus on higher levels of patient participation, and increasing the breadth and depth of information and processes to ensure patient record curation and stewardship.
There appears to be strong clinician support for digital access to PMH in ED and UC; however, current systems appear to have many shortcomings.
探索急诊科（ED）和紧急护理（UC）临床医生对患者既往病史（PMH）数字化访问的看法。
一项在线调查比较了对数字 PMH 访问的预期和实际价值。采用统一技术接受和使用理论 2（UTAUT2）评估技术接受度。使用曼-惠特尼 U 检验对定量数据进行分析，对定性数据采用一般归纳法进行分析。
共收到 33 份回复。94%（16/17）有 PMH 访问权限的受访者表示他们重视自己的 PMH 系统，所有没有数字 PMH 访问权限的受访者（100%；16/16）都表示他们认为访问权限将具有价值。两个组在 UTAUT2 的所有维度上都表现出较高的技术接受度。自由文本回复表明，可以改进的地方包括增加可提供的患者记录数量、标准化信息呈现、提高系统可靠性、扩大信息访问权限以及由权威/可信来源进行验证。
没有 PMH 访问权限的受访者的期望与 PMH 受访者获得的益处非常匹配。高水平的技术接受度表明了强烈的采用意愿。临床医生似乎很清楚他们希望对 PMH 内容和访问权限进行哪些改进。政策含义包括需要关注患者参与度的提高，以及增加信息和流程的广度和深度，以确保患者记录的管理和维护。
ED 和 UC 临床医生似乎强烈支持数字化访问 PMH，但当前系统似乎存在许多缺陷。
