Goldstein Neal D
Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
Qual Health Res. 2024 Jun 3:10497323241245644. doi: 10.1177/10497323241245644.
Electronic health records (EHRs) have become ubiquitous in clinical practice. Given the rich biomedical data captured for a large panel of patients, secondary analysis of these data for health research is also commonplace. Yet, there are many caveats to EHR data that the researchers must be aware of, such as the accuracy of and motive for documentation, and the reason for patients' visits to the clinic. The clinician-the author of the documentation-is thus central to the correct interpretation of EHR data for research purposes. In this study, I interviewed 11 physicians in various clinical specialties to bring attention to their view on the validity of research using EHR data. Qualitative, in-depth, one-on-one interviews were conducted with practicing physicians in inpatient and outpatient medicine. Content analysis using a data-driven, inductive approach to identify themes related to challenges and opportunities in the reuse of EHR data for secondary analysis generated seven themes. Themes that reflected challenges of EHRs for research included (1) audience, (2) accuracy of data, (3) availability of data, (4) documentation practices, and (5) representativeness. Themes that reflected opportunities of EHRs for research included (6) endorsement and (7) enablers. The greatest perceived barriers reflected the intended audience of the EHR, the interpretation and meaning of the data, and the quality of the data for research purposes. Physicians generally expressed more perceived challenges than opportunities in the reuse of EHR data for research purposes; however, they remained optimistic.
电子健康记录（EHRs）在临床实践中已无处不在。鉴于为大量患者收集了丰富的生物医学数据，对这些数据进行二次分析以用于健康研究也很常见。然而，研究人员必须了解电子健康记录数据存在的许多注意事项，例如记录的准确性和动机，以及患者就诊的原因。因此，作为记录作者的临床医生对于正确解释用于研究目的的电子健康记录数据至关重要。在本研究中，我采访了11位不同临床专科的医生，以了解他们对使用电子健康记录数据进行研究的有效性的看法。对住院和门诊医学领域的执业医生进行了定性、深入的一对一访谈。采用数据驱动的归纳方法进行内容分析，以确定与电子健康记录数据二次分析中的挑战和机遇相关的主题，共产生了七个主题。反映电子健康记录在研究方面挑战的主题包括：（1）受众，（2）数据准确性，（3）数据可用性，（4）记录做法，以及（5）代表性。反映电子健康记录在研究方面机遇的主题包括：（6）认可，以及（7）促成因素。最大的感知障碍反映了电子健康记录的目标受众、数据的解释和意义，以及用于研究目的的数据质量。医生们普遍表示，在将电子健康记录数据用于研究目的时，感知到的挑战比机遇更多；然而，他们仍然持乐观态度。
