Office of the National Coordinator for Health Information Technology, Washington, DC.
American Board of Family Medicine, Lexington, Kentucky.
JAMA Netw Open. 2024 Mar 4;7(3):e243793. doi: 10.1001/jamanetworkopen.2024.3793.
Enabling widespread interoperability-the ability of health information technology systems to exchange information and to use that information without special effort-is a primary focus of public policy on health information technology. More information on clinicians' experience using that technology can serve as one measure of the impact of that policy.
To assess primary care physician perspectives on the state of interoperability.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional survey of family medicine physicians in the US was conducted from December 12, 2021, to October 12, 2022. A sample of family medicine physicians who completed the Continuous Certification Questionnaire (CCQ), a required part of the American Board of Family Medicine certification process, which has a 100% response rate, were invited to participate.
Eighteen items on the CCQ assessed experience accessing and using various information from outside organizations, including medications, immunizations, and allergies.
A total of 2088 physicians (1053 women [50%]; age reported categorically as either ≥50 years or <50 years) completed the CCQ interoperability questions in 2022. Of these respondents, 35% practiced in hospital or health system-owned practices, while 27% practiced in independently owned practices. Eleven percent were very satisfied with their ability to electronically access all 10 types of information from outside organizations included on the questionnaire, and a mean of 70% were at least somewhat satisfied. A total of 23% of family medicine physicians reported information from outside organizations was very easy to use, and an additional 65% reported that information was somewhat easy to use. Only 8% reported that information from different electronic health record (EHR) developers' products was very easy to use compared with 38% who reported information from the same EHR developer's product was very easy to use.
This survey study of family medicine physicians found modest and uneven improvement in physicians' experience with interoperability. These findings suggest that substantial heterogeneity in satisfaction by information type, source of information, EHR, practice type, ownership, and patient population necessitates diverse policy and strategies to improve interoperability.
使健康信息技术系统能够进行信息交换并在无需特殊努力的情况下使用这些信息的广泛互操作性-是健康信息技术公共政策的主要重点。更多关于临床医生使用该技术的经验的信息可以作为该政策影响的一个衡量标准。
评估初级保健医生对互操作性现状的看法。
设计、设置和参与者:对美国的家庭医学医师进行了横断面调查。调查于 2021 年 12 月 12 日至 2022 年 10 月 12 日进行。邀请完成美国家庭医学委员会认证过程中必需部分的连续认证问卷(CCQ)的家庭医学医师样本参加,该问卷的应答率为 100%。
CCQ 上的 18 个项目评估了从外部组织访问和使用各种信息(包括药物、免疫接种和过敏)的经验。
共有 2088 名医生(1053 名女性[50%];年龄报告为≥50 岁或<50 岁)在 2022 年完成了 CCQ 互操作性问题。在这些回答者中,35%的人在医院或医疗系统所有的医疗机构中执业,而 27%的人在独立拥有的医疗机构中执业。11%的人对他们从调查问卷中包含的 10 种类型的外部组织的电子访问能力非常满意,平均有 70%的人至少有些满意。共有 23%的家庭医学医师报告说,外部组织的信息非常易于使用,另外还有 65%的人报告说信息比较容易使用。只有 8%的人报告说来自不同电子健康记录(EHR)开发商产品的信息非常易于使用,而 38%的人报告说来自同一 EHR 开发商产品的信息非常易于使用。
这项针对家庭医学医师的调查研究发现,医师在互操作性方面的经验有适度和不均衡的改善。这些发现表明,信息类型、信息来源、EHR、实践类型、所有权和患者群体的满意度存在很大的异质性,需要采取不同的政策和策略来改善互操作性。