Sisk Bryan A, Lin Sunny, Balls-Berry Joyce Joy E, Servin Argentina E, Mack Jennifer W
Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
JAMIA Open. 2023 Jul 7;6(3):ooad049. doi: 10.1093/jamiaopen/ooad049. eCollection 2023 Oct.
The aim of this study was to understand the influence of clinician encouragement and sociodemographic factors on whether patients access online electronic medical records (EMR).
We analyzed 3279 responses from the Health Information National Trends Survey 5 cycle 4 survey, a cross-sectional, nationally representative survey administered by the National Cancer Institute. Frequencies and weighted proportions were calculated to compare clinical encouragement and access to their online EMR. Using multivariate logistic regression, we identified factors associated with online EMR use and clinician encouragement.
In 2020, an estimated 42% of US adults accessed their online EMR and 51% were encouraged by clinicians to access their online EMR. In multivariate regression, respondents who accessed EMR were more likely to have received clinician encouragement (odds ratio [OR], 10.3; 95% confidence interval [CI], 7.7-14.0), college education or higher (OR, 1.9; 95% CI, 1.4-2.7), history of cancer (OR, 1.5; 95% CI, 1.0-2.3), and history of chronic disease (OR, 2.3; 95% CI, 1.7-3.2). Male and Hispanic respondents were less likely to have accessed EMR than female and non-Hispanic White respondents (OR, 0.6; 95% CI, 0.5-0.8, and OR, 0.5; 95% CI, 0.3-0.8, respectively). Respondents receiving encouragement from clinicians were more likely to be female (OR, 1.7; 95% CI, 1.3-2.3), have college education (OR, 1.5; 95% CI, 1.1-2.0), history of cancer (OR, 1.8; 95% CI, 1.3-2.5), and greater income levels (OR, 1.8-3.6).
Clinician encouragement of patient EMR use is strongly associated with patients accessing EMR, and there are disparities in who receives clinician encouragement related to education, income, sex, and ethnicity.
Clinicians have an important role to ensure that all patients benefit from online EMR use.
本研究旨在了解临床医生的鼓励以及社会人口统计学因素对患者获取在线电子病历（EMR）的影响。
我们分析了来自美国国立癌症研究所开展的全国健康信息趋势调查第5周期第4轮调查的3279份回复，这是一项具有全国代表性的横断面调查。计算频率和加权比例以比较临床鼓励措施与在线电子病历获取情况。通过多变量逻辑回归分析，我们确定了与在线电子病历使用及临床医生鼓励相关的因素。
2020年，估计42%的美国成年人获取了其在线电子病历，51%的人受到临床医生鼓励去获取在线电子病历。在多变量回归分析中，获取电子病历的受访者更有可能受到临床医生的鼓励（比值比[OR]为10.3；95%置信区间[CI]为7.7 - 14.0），拥有大学及以上学历（OR为1.9；95% CI为1.4 - 2.7），有癌症病史（OR为1.5；95% CI为1.0 - 2.3），以及有慢性病病史（OR为2.3；95% CI为1.7 - 3.2）。男性和西班牙裔受访者获取电子病历的可能性低于女性和非西班牙裔白人受访者（OR分别为0.6；95% CI为0.5 - 0.8，以及OR为0.5；95% CI为0.3 - 0.8）。受到临床医生鼓励的受访者更有可能为女性（OR为1.7；95% CI为1.3 - 2.3），拥有大学学历（OR为1.5；95% CI为1.1 - 2.0），有癌症病史（OR为1.8；95% CI为1.3 - 2.5），以及收入水平更高（OR为1.8 - 3.6）。
临床医生对患者使用电子病历的鼓励与患者获取电子病历密切相关，在受到临床医生鼓励方面，不同教育程度、收入、性别和种族的人群存在差异。
临床医生在确保所有患者从在线电子病历使用中受益方面发挥着重要作用。
