Stabler Meagan E, Westfall John M, Nease Donald E, Raymond Jennifer, Jobse Bruce, Daudier Zoe, Emanuele Laurie, Wilson Elisabeth, Boardman Maureen, Korsen Neil, MacLean Charles D, van Eeghen Constance, Hudon Paula S, Burdick Timothy E
From the Department of Community and Family Medicine, Dartmouth Health, Lebanon, NH (MES, JW, JR, BJ, ZD, LE, EW, MB, PSH, TEB); Department of Family Medicine, University of Colorado - Anschutz Medical Campus, School of Medicine, Aurora, CO (JW, DEN); Colorado Clinical and Translational Sciences Institute, University of Colorado - Anschutz Medical Campus, Aurora, CO (DEN); Little Rivers Health Care, Bradford, VT (MB); Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Scarborough, ME (NK); Division of Public Health, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT (CDM, CVE); Department of Biomedical Data Sciences, Geisel School of Medicine, Hanover, NH (CDM, TEB); The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Hanover, NH (TEB); SYNERGY Clinical and Translational Research Institute, Dartmouth Health, Lebanon, NH (TEB).
J Am Board Fam Med. 2025 May 12;38(1):46-55. doi: 10.3122/jabfm.2024.240199R1.
For decades, researchers have utilized paper card studies to assess primary care clinician (PCC) perceptions across various clinical and practice topics. Since 2022, cards can be completed electronically through the electronic health record (EHR) or a novel smartphone application (app). These delivery modalities have not previously been evaluated head-to-head. We report findings from a work in progress comparing paper, EHR, and app-delivered cards.
The Northern New England CO-OP Practice and Community Based Research Network recruited 15 PCCs from 3 clinics to collect a total of 324 cards from unique patient visits over 4 clinical days per PCC on the topic of "telehealth burden." Each clinic utilized a different data collection modality and collected approximately 100 cards. After completing the cards, we surveyed PCCs about their user experience. Our primary outcomes were PCC experience, card completion rates, and total cost of using the cards.
PCCs reported that data collection was easy and the card study did not disrupt clinical operations regardless of modality. Paper cards had the highest completion rate and were least expensive for a small-scale card study, but were most expensive when scaled due to the large amount of time to transcribe data manually. EHR was the most expensive modality for a small-scale card study, but EHR and app cards scaled better than paper.
While each modality has distinct advantages and disadvantages, all 3 card study data collection methods were acceptable to PCCs and obtained a high response rate.
几十年来,研究人员一直利用纸质卡片研究来评估基层医疗临床医生(PCC)对各种临床和实践主题的看法。自2022年以来,可以通过电子健康记录(EHR)或新型智能手机应用程序(应用)以电子方式完成卡片填写。此前尚未对这些交付方式进行过直接比较评估。我们报告了一项正在进行的比较纸质、EHR和应用程序交付卡片的研究结果。
新英格兰北部合作医疗实践与社区研究网络从3家诊所招募了15名基层医疗临床医生,在每个基层医疗临床医生的4个临床日期间,从独特的患者就诊中总共收集324张关于“远程医疗负担”主题的卡片。每家诊所采用不同的数据收集方式,收集了大约100张卡片。完成卡片填写后,我们对基层医疗临床医生进行了关于其用户体验的调查。我们的主要结果是基层医疗临床医生的体验、卡片完成率以及使用卡片的总成本。
基层医疗临床医生报告称,无论采用何种方式,数据收集都很容易,并且卡片研究不会干扰临床操作。纸质卡片的完成率最高,对于小规模卡片研究来说成本最低,但由于手动转录数据需要大量时间,在扩大规模时成本最高。对于小规模卡片研究,EHR是最昂贵的方式,但EHR和应用程序卡片在扩大规模时比纸质卡片表现更好。
虽然每种方式都有其独特的优缺点,但所有三种卡片研究数据收集方法对基层医疗临床医生来说都是可以接受的,并且获得了很高的响应率。