Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran; Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Int J Med Inform. 2024 Dec;192:105622. doi: 10.1016/j.ijmedinf.2024.105622. Epub 2024 Sep 5.
The need for dental data in healthcare services and the inadequacy of paper records due to their inherent limitations have led to a shift towards electronic dental record systems (EDR). Implementing EDR comes with numerous barriers and challenges. Therefore, this research was conducted to identify the implementation barriers and facilitators for EDRs.
This descriptive-analytical cross-sectional study was conducted on dentists working in public and private clinics in Tehran, Iran. A questionnaire consisting of three sections was designed to collect data on the demographic information of dentists, the barriers in five categories including financial barriers (6 questions), organizational barriers (11 questions), technical barriers (5 questions), personal barriers (3 questions), and ethical and legal barriers (6 questions), as well as facilitators for the implementation of EDR (15 questions) based on the literature, using a five-point Likert scale. 130 dentists from 60 dental clinics participated in the study. The data were analyzed using descriptive statistics (calculating frequency distribution, mean, and standard deviation). The mean scores were classified into four categories based on quartiles from very low importance to very high importance including very low importance (mean ≤ 1.25), low importance (1.25 ≥ mean < 2.5), important (2.5 ≥ mean < 3.75), and very high importance (mean ≥ 3.75). Finally, each of the barriers and facilitators among user dentists and non-user dentists was compared using the Mann-Whitney U test. The data were analyzed using SPSS software.
The findings indicate that dentists consider all barriers and challenges in implementing EDR to be important, and all the proposed facilitators for addressing these challenges to be very important. Among these important barriers are the rapid turnover of managers and policymakers at higher levels (3.69 out of 5) as a personal barrier, legal issues related to electronic records (3.65 out of 5) as an ethical-legal barrier, the lack of necessary standards for data exchange between different systems (3.64 out of 5) as a technical barrier, dentists' limited awareness of the benefits of this system (3.63 out of 5) as a personal barrier, and the lack of suitable legal infrastructure for EDR implementation (3.62 out of 5) as an ethical-legal barrier. Additionally, among the very important facilitators, training dentists and staff on EDR (4.31 out of 5) is noteworthy.
To address the important barriers to EDR implementation, including legal-ethical barriers, legal institutions, and regulators must establish relevant laws and regulations to overcome these obstacles. Furthermore, if system users learn about the features, goals, benefits, and positive impact of EDR on their work and gain the necessary awareness, their resistance to changes will decrease, and their interest and readiness to accept EDR will increase.
医疗服务中对牙科数据的需求以及纸质记录固有的局限性,导致人们转向电子牙科记录系统(EDR)。实施 EDR 面临着诸多障碍和挑战。因此,本研究旨在确定实施 EDR 的障碍和促进因素。
本研究采用描述性分析性的横断面研究方法,对伊朗德黑兰市公立和私立诊所的牙医进行了调查。研究设计了一份包含三个部分的问卷,用于收集牙医的人口统计学信息、五个类别的障碍(财务障碍[6 个问题]、组织障碍[11 个问题]、技术障碍[5 个问题]、个人障碍[3 个问题]和伦理法律障碍[6 个问题])以及基于文献的 EDR 实施的促进因素(15 个问题)的信息,采用 5 点李克特量表进行评估。共有 60 家牙科诊所的 130 名牙医参与了这项研究。使用描述性统计(计算频率分布、均值和标准差)对数据进行分析。根据四分位数将平均得分分为四个类别,包括非常不重要(均值≤1.25)、不重要(1.25<均值<2.5)、重要(2.5<均值<3.75)和非常重要(均值≥3.75)。最后,使用曼-惠特尼 U 检验比较用户牙医和非用户牙医之间的每个障碍和促进因素。数据使用 SPSS 软件进行分析。
研究结果表明,牙医认为实施 EDR 的所有障碍和挑战都很重要,所有提出的解决这些挑战的促进因素都非常重要。其中重要的障碍包括高层管理人员和政策制定者的快速更替(5 分制中得 3.69 分),作为个人障碍;与电子记录相关的法律问题(5 分制中得 3.65 分),作为伦理法律障碍;不同系统之间数据交换缺乏必要的标准(5 分制中得 3.64 分),作为技术障碍;牙医对该系统的益处认识有限(5 分制中得 3.63 分),作为个人障碍;以及缺乏适合 EDR 实施的法律基础设施(5 分制中得 3.62 分),作为伦理法律障碍。此外,非常重要的促进因素之一是对牙医和员工进行 EDR 培训(5 分制中得 4.31 分)。
为了解决 EDR 实施的重要障碍,包括法律伦理障碍,法律机构和监管机构必须制定相关法律和法规来克服这些障碍。此外,如果系统用户了解 EDR 的功能、目标、好处和对他们工作的积极影响,并获得必要的意识,他们对变革的抵制就会减少,对 EDR 的兴趣和接受度就会提高。