Benjamins Janine, Duinkerken Jan-Gerrit, den Hamer-Jordaan Gerlinde, Canfijn Romay, Koster Rianne, de Vet Emely, Haveman-Nies Annemien
Icare JGZ, Blankenstein 550, 7943 PA, Meppel, the Netherlands.
Wageningen University and Research, Chairgroup Consumption and Healthy Lifestyles, Hollandseweg 1, 6707 KN, Wageningen, the Netherlands.
Int J Integr Care. 2023 Jun 16;23(2):26. doi: 10.5334/ijic.6905. eCollection 2023 Apr-Jun.
Client-accessible interdisciplinary health records potentially contribute to integrated care by facilitating collaboration and enhancing clients' involvement in care. To achieve this, three Dutch organizations providing 'care for youth' developed a fully client-accessible electronic patient record (EPR-Youth).
To evaluate the implementation of EPR-Youth and to determine barriers and facilitators.
A mixed methods design combined system data, process observations, questionnaires and focus group interviews. Target groups were parents, adolescents, professionals using EPR-Youth, and implementation stakeholders.
Client-portal acceptability was high among all clients. Client-portal adoption rate was high and differed between age groups and educational levels. Professionals' doubts about acceptability, appropriateness and fidelity were partly due to lack of system knowledge. Implementation barriers were the complexity of co-creation, lack of clear leadership, and concerns about legal issues. Facilitators were clarifying vision and legal context, setting deadlines, and a pioneering spirit.
The early implementation of EPR-Youth, the first Dutch client-accessible interdisciplinary electronic health record in 'care for youth' was successful. To enhance adoption among clients, group-specific barriers for portal-use should be determined. Professionals need additional training. Further research is needed to gain insight into client-portal access barriers. To benefit more from co-creation, an organizational change towards situational leadership is necessary.
客户可访问的跨学科健康记录通过促进协作和增强客户对护理的参与度，有可能推动综合护理。为实现这一目标，荷兰三个提供“青少年护理”的组织开发了一个完全由客户可访问的电子病历（EPR-Youth）。
评估EPR-Youth的实施情况，并确定障碍和促进因素。
采用混合方法设计，结合系统数据、过程观察、问卷调查和焦点小组访谈。目标群体包括家长、青少年、使用EPR-Youth的专业人员以及实施利益相关者。
所有客户对客户门户的接受度都很高。客户门户的采用率很高，且在年龄组和教育水平之间存在差异。专业人员对可接受性、适当性和保真度的疑虑部分是由于缺乏系统知识。实施障碍包括共同创造的复杂性、缺乏明确的领导以及对法律问题的担忧。促进因素包括明确愿景和法律背景、设定最后期限以及开拓精神。
EPR-Youth的早期实施取得了成功，它是荷兰首个在“青少年护理”领域客户可访问的跨学科电子健康记录。为提高客户中的采用率，应确定特定群体使用门户的障碍。专业人员需要额外培训。需要进一步研究以深入了解客户门户访问障碍。为了从共同创造中获得更多益处，有必要向情境领导进行组织变革。
