Trinity Centre Practice & Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24, D'olier St, Dublin 2, Ireland.
Trinity Centre Practice & Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24, D'olier St, Dublin 2, Ireland.
Int J Med Inform. 2024 May;185:105399. doi: 10.1016/j.ijmedinf.2024.105399. Epub 2024 Feb 28.
Implementation of an Electronic Patient Record (EPR) in a key milestone in the digital strategy of modern healthcare organisations. The implementation of EPR systems can be viewed as challenging and complex.
The aim of the study was to investigate user perspectives and experiences of the implementation of an Electronic Medical Record in a major academic teaching hospital, with simultaneous 'go-live' across the whole hospital taking place.
Focus groups and individual in-depth interviews were conducted with stakeholders and users (n = 105), approximately nine months post-EPR implementation. The study explored EPR users' perceptions using an extended theoretical framework of the DeLone and McLean Information Systems Success Model (2003), which measured information systems, system quality, information quality, service quality, use/perceived usefulness & user satisfaction and net benefits.
Staff engagement and satisfaction was high and the EPR is accepted as the new standard way of completing care. There was agreement that the EPR affords transparency, and greater accountability. There was some concern expressed regarding impact of the EPR on interprofessional and patient/provider interactions and communication. Physicians reported the inputting of social history through free text as an issue of concern and time consuming. The Big Bang approach with mandatory conversion was key to the successful adoption of EPR. There was consensus across professional and administrative respondents that there was no appetite to return to paper-based records.
The successful roll out of the EPR reflects the digital readiness of healthcare providers and organisations. The potential for unintended consequences on work process requires continual monitoring. A key future benefit of the EPR will be the capacity to reach a broader understanding and analysis of variation in processes and outcomes within healthcare organisations. It is clear that skills in data analytics will be needed to mine data successfully.
电子病历(EPR)的实施是现代医疗机构数字化战略的一个关键里程碑。EPR 系统的实施可以被视为具有挑战性和复杂性。
本研究旨在调查在一家主要的学术教学医院实施电子病历时,用户的观点和体验,同时整个医院同时进行“上线”。
大约在 EPR 实施九个月后,对利益相关者和用户(n=105)进行了焦点小组和个人深入访谈。该研究使用扩展的 DeLone 和 McLean 信息系统成功模型(2003 年)的理论框架来探讨 EPR 用户的感知,该框架衡量了信息系统、系统质量、信息质量、服务质量、使用/感知有用性和用户满意度以及净收益。
员工的参与度和满意度很高,EPR 被接受为完成护理的新标准。人们一致认为 EPR 提供了透明度,并提高了问责制。有人表示担心 EPR 会对专业间和患者/提供者的互动和沟通产生影响。医生报告说,通过自由文本输入社会史是一个令人担忧和耗时的问题。强制性转换的“大爆炸”方法是成功采用 EPR 的关键。专业和行政受访者一致认为,没有回归纸质记录的意愿。
EPR 的成功推出反映了医疗保健提供者和组织的数字化准备程度。工作流程中可能出现意外后果,需要持续监测。EPR 的一个关键未来利益将是能够更广泛地了解和分析医疗保健组织内流程和结果的变化。显然,需要数据分析技能来成功挖掘数据。