School Public Health and Preventative Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
Cabrini Health, 181-183 Wattletree Rd, Malvern, VIC, 3144, Australia.
BMC Med Inform Decis Mak. 2022 Jul 5;22(1):178. doi: 10.1186/s12911-022-01920-8.
The emergency department has been a major focus for the implementation of Australia's national electronic health record, known as My Health Record. However, the association between use of My Health Record in the emergency department setting and patient care is largely unknown. The aim of this study was to explore the perspectives of emergency department clinicians regarding My Health Record use frequency, the benefits of My Health Record use (with a focus on patient care) and the barriers to use.
All 393 nursing, pharmacy, physician and allied health staff employed within the emergency department at a tertiary metropolitan public hospital in Melbourne were invited to participate in a web-based survey, between 1 May 2021 and 1 December 2021, during the height of the Delta and Omicron Covid-19 outbreaks in Victoria, Australia.
Overall, the survey response rate was 18% (70/393). Approximately half of the sample indicated My Health Record use in the emergency department (n = 39, 56%, confidence interval [CI] 43-68%). The results showed that users typically only engaged with My Health Record less than once per shift (n = 15, 39%, CI 23-55%). Just over half (n = 19/39, 54%, CI 32-65%) of all participants who use My Health Record agreed they could remember a time when My Health Record had been critical to the care of a patient. Overall, clinicians indicated the biggest barrier preventing their use of My Health Record is that they forget to utilise the system.
The results suggest that My Health Record has not been adopted as routine practice in the emergency department, by the majority of participants. Close to half of self-identified users of My Health Record do not associate use as being critical to patient care. Instead, My Health Record may only be used in scenarios that clinicians perceive will yield the greatest benefit-which clinicians in this paper suggest is patients with chronic and complex conditions. Further research that explores the predictors to use and consumers most likely to benefit from use is recommended-and strategies to socialise this knowledge and educate clinicians is desperately required.
急诊科一直是澳大利亚国家电子健康记录(简称“My Health Record”)实施的重点。然而,在急诊科使用 My Health Record 与患者护理之间的关联在很大程度上尚不清楚。本研究旨在探讨急诊科临床医生对 My Health Record 使用频率、使用益处(重点关注患者护理)以及使用障碍的看法。
2021 年 5 月 1 日至 12 月 1 日期间,在澳大利亚维多利亚州 Delta 和 Omicron 新冠疫情高峰期,邀请墨尔本一家三级大都市公立医院急诊科的 393 名护理、药剂、医生和辅助医疗人员参与了一项基于网络的调查。
总体而言,调查的回复率为 18%(70/393)。约有一半的样本表示在急诊科使用过 My Health Record(n=39,56%,置信区间 [CI] 43-68%)。结果表明,用户通常每次轮班仅使用 My Health Record 不到一次(n=15,39%,CI 23-55%)。所有使用 My Health Record 的参与者中,略多于一半(n=19/39,54%,CI 32-65%)的人表示,他们记得有一次 My Health Record 对患者的护理至关重要。总体而言,临床医生表示,阻止他们使用 My Health Record 的最大障碍是他们忘记使用该系统。
结果表明,My Health Record 尚未成为大多数参与者在急诊科的常规做法。近一半自我认定的 My Health Record 用户并不认为使用该系统对患者护理至关重要。相反,My Health Record 可能仅在临床医生认为最能带来益处的情况下使用,而在本文中,临床医生认为这是患有慢性和复杂疾病的患者。建议进一步研究使用的预测因素和最有可能从中受益的患者,并迫切需要制定策略来宣传这方面的知识并对临床医生进行教育。