American Board of Family Medicine, Lexington, KY 40511, United States.
Center for Professionalism and Value in Health Care, Washington, DC 20036, United States.
J Am Med Inform Assoc. 2024 Aug 1;31(8):1754-1762. doi: 10.1093/jamia/ocae148.
To identify impacts of different survey methodologies assessing primary care physicians' (PCPs') experiences with electronic health records (EHRs), we compared three surveys: the 2022 Continuous Certification Questionnaire (CCQ) from the American Board of Family Medicine, the 2022 University of California San Francisco (UCSF) Physician Health IT Survey, and the 2021 National Electronic Health Records Survey (NEHRS).
We evaluated differences between survey pairs using Rao-Scott corrected chi-square tests, which account for weighting.
CCQ received 3991 responses from PCPs (100% response rate), UCSF received 1375 (3.6% response rate), and NEHRS received 858 (18.2% response rate). Substantial, statistically significant differences in demographics were detected across the surveys. CCQ respondents were younger and more likely to work in a health system; NEHRS respondents were more likely to work in private practice; and UCSF respondents disproportionately practiced in larger academic settings. Many EHR experience indicators were similar between CCQ and NEHRS, but CCQ respondents reported higher documentation burden.
The UCSF approach is unlikely to supply reliable data. Significant demographic differences between CCQ and NEHRS raise response bias concerns, and while there were similarities in some reported EHR experiences, there were important, significant differences.
Federal EHR policy monitoring and maintenance require reliable data. This test of existing and alternative sources suggest that diversified data sources are necessary to understand physicians' experiences with EHRs and interoperability. Comprehensive surveys administered by specialty boards have the potential to contribute to these efforts, since they are likely to be free of response bias.
为了确定评估初级保健医生(PCP)使用电子健康记录(EHR)体验的不同调查方法的影响,我们比较了三个调查:美国家庭医学委员会的 2022 年持续认证问卷(CCQ)、2022 年加州大学旧金山分校(UCSF)医生健康信息技术调查和 2021 年国家电子健康记录调查(NEHRS)。
我们使用 Rao-Scott 校正卡方检验比较了调查对之间的差异,该检验考虑了权重。
CCQ 收到了来自 3991 名 PCP 的回复(100%回复率),UCSF 收到了 1375 名回复(3.6%回复率),而 NEHRS 收到了 858 名回复(18.2%回复率)。在调查之间检测到人口统计学上的显著差异。CCQ 的受访者更年轻,更有可能在医疗系统工作;NEHRS 的受访者更有可能在私人诊所工作;而 UCSF 的受访者则不成比例地在更大的学术环境中执业。CCQ 和 NEHRS 之间的许多 EHR 体验指标相似,但 CCQ 的受访者报告了更高的文档负担。
UCSF 的方法不太可能提供可靠的数据。CCQ 和 NEHRS 之间存在显著的人口统计学差异,引起了对回应偏差的担忧,尽管一些报告的 EHR 经验存在相似之处,但也存在重要的显著差异。
联邦 EHR 政策监测和维护需要可靠的数据。对现有和替代来源的测试表明,需要多样化的数据来源来了解医生使用 EHR 和互操作性的经验。专业委员会管理的全面调查有可能为此做出贡献,因为它们可能没有回应偏差。