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医疗保健的声音:将数字决策支持系统引入临床实践 - 一项定性研究。

The voice of healthcare: introducing digital decision support systems into clinical practice - a qualitative study.

机构信息

Study Programme in Medicine, Karolinska Institutet, Stockholm, Sweden.

Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Stockholm, Sweden.

出版信息

BMC Prim Care. 2023 Mar 13;24(1):67. doi: 10.1186/s12875-023-02024-6.

Abstract

BACKGROUND

There is a need to accelerate digital transformation in healthcare to meet increasing needs and demands. The accuracy of medical digital diagnosis tools is improving. The introduction of new technology in healthcare can however be challenging and it is unclear how it should be done to reach desired results. The aim of this study was to explore perceptions and experiences of introducing new Information Technology (IT) in a primary healthcare organisation, exemplified with a Clinical Decision Support System (CDSS) for malignant melanoma.

METHODS

A qualitative interview-based study was performed in Region Stockholm, Sweden, with fifteen medical doctors representing three different organisational levels - primary care physician, primary healthcare centre manager, and regional manager/chief medical officer. In addition, one software provider was included. Interview data were analysed according to content analysis.

RESULTS

One central theme "Introduction of digital CDSS in primary healthcare requires a multidimensional perspective and handling" along with seven main categories and thirty-three subcategories emerged from the analysis. Digital transformation showed to be key for current healthcare providers to stay relevant and competitive. However, healthcare represents a closed community, very capable but with lack of time, fostered to be sceptical to new why change needs to bring true value and be inspired by people with medical background to motivate the powerful frontline.

CONCLUSIONS

This qualitative study revealed structured information of what goes wrong and right and what needs to be considered when driving digital change in primary care organisations. The task shows to be complex and the importance of listening to the voice of healthcare is valuable for understanding the conditions that need to be fulfilled when adopting new technology into a healthcare organization. By considering the findings of this study upcoming digital transformations can improve their success-rate. The information may also be used in developing a holistic approach or framework model, adapted to primary health care, that can support and accelerate the needed digitalization in healthcare as such.

摘要

背景

医疗保健领域需要加速数字化转型,以满足日益增长的需求。医学数字诊断工具的准确性不断提高。然而,引入新的医疗技术可能具有挑战性,并且不清楚应该如何做才能达到预期的结果。本研究旨在探讨在基层医疗组织中引入新的信息技术(IT)的看法和经验,以黑色素瘤临床决策支持系统(CDSS)为例。

方法

在瑞典斯德哥尔摩地区进行了一项基于定性访谈的研究,参与者包括 15 名医生,代表三个不同的组织级别——初级保健医生、初级保健中心经理和区域经理/首席医疗官。此外,还包括一名软件提供商。对访谈数据进行了内容分析。

结果

分析得出一个核心主题“在初级保健中引入数字化 CDSS 需要多维视角和处理”,以及七个主要类别和三十三个子类别。数字化转型对于当前的医疗保健提供者来说是保持相关性和竞争力的关键。然而,医疗保健行业是一个封闭的社区,他们非常有能力,但缺乏时间,对新事物持怀疑态度,认为新事物需要带来真正的价值,并受到有医学背景的人的启发,以激励一线人员。

结论

这项定性研究揭示了在基层医疗组织中推动数字化变革时可能出现的错误和正确之处,以及需要考虑的事项。这项任务非常复杂,倾听医疗保健领域的声音对于理解在医疗保健组织中采用新技术所需满足的条件是有价值的。通过考虑本研究的发现,未来的数字化转型可以提高其成功率。这些信息也可用于开发适用于基层医疗保健的整体方法或框架模型,以支持和加速医疗保健领域的数字化转型。

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