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评估加拿大一家心理健康组织中医生参与五年后对电子健康记录负担的影响:混合方法研究。

Assessing the Impact on Electronic Health Record Burden After Five Years of Physician Engagement in a Canadian Mental Health Organization: Mixed-Methods Study.

作者信息

Tajirian Tania, Lo Brian, Strudwick Gillian, Tasca Adam, Kendell Emily, Poynter Brittany, Kumar Sanjeev, Chang Po-Yen Brian, Kung Candice, Schachter Debbie, Zai Gwyneth, Kiang Michael, Hoppe Tamara, Ling Sara, Haider Uzma, Rabel Kavini, Coombe Noelle, Jankowicz Damian, Sockalingam Sanjeev

机构信息

Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.

Centre for Addiction and Mental Health, Office 6168G, 100 Stokes Street, Toronto, ON, Canada, 1 (416) 535-8501 ext 30515.

出版信息

JMIR Hum Factors. 2025 May 9;12:e65656. doi: 10.2196/65656.

Abstract

BACKGROUND

The burden caused by the use of electronic health record (EHR) systems continues to be an important issue for health care organizations, especially given human resource shortages in health care systems globally. As physicians report spending 2 hours documenting for every hour of patient care, there has been strong interest from many organizations to understand and address the root causes of physician burnout due to EHR burden.

OBJECTIVE

This study focuses on evaluating physician burnout related to EHR usage and the impact of a physician engagement strategy at a Canadian mental health organization 5 years after implementation.

METHODS

A cross-sectional survey was conducted to assess the perceived impact of the physician engagement strategy on burnout associated with EHR use. Physicians were invited to participate in a web-based survey that included the Mini-Z Burnout questionnaire, along with questions about their perceptions of the EHR and the effectiveness of the initiatives within the physician engagement strategy. Descriptive statistics were applied to analyze the quantitative data, while thematic analysis was used for the qualitative data.

RESULTS

Of the 254 physicians invited, 128 completed the survey, resulting in a 50% response rate. Among the respondents, 26% (33/128) met the criteria for burnout according to the Mini-Z questionnaire, with 61% (20/33) of these attributing their burnout to EHR use. About 52% of participants indicated that the EHR improves communication (67/128) and 38% agreed that the EHR enables high-quality care (49/128). Regarding the physician engagement strategy initiatives, 39% (50/128) agreed that communication through the strategy is efficient, and 75% (96/128) felt more proficient in using the EHR. However, additional areas for improvement within the EHR were identified, including (1) medication reconciliation and prescription processes; (2) chart navigation and information retrieval; (3) longitudinal medication history; and (4) technology infrastructure challenges.

CONCLUSIONS

This study highlights the potential impact of EHRs on physician burnout and the effectiveness of a unique physician engagement strategy in fostering positive perceptions and improving EHR usability among physicians. By evaluating this initiative in a real-world setting, the study contributes to the broader literature on strategies aimed at enhancing physician experience following large-scale EHR implementation. However, the findings indicate a continued need for system-level improvements to maximize the value and usage of EHRs. The physician engagement strategy demonstrates the potential to enhance physicians' EHR experience. Future efforts should prioritize system-level advancements to increase the EHR's impact on quality of care and develop standardized approaches for engaging physicians on a broader Canadian scale.

摘要

背景

电子健康记录(EHR)系统的使用所带来的负担,对于医疗保健机构而言仍然是一个重要问题,尤其是考虑到全球医疗保健系统存在人力资源短缺的情况。由于医生报告称每进行一小时的患者护理就要花费两小时进行记录,许多机构都对了解并解决因EHR负担导致医生职业倦怠的根本原因有着浓厚兴趣。

目的

本研究聚焦于评估在一家加拿大心理健康机构实施EHR五年后,与EHR使用相关的医生职业倦怠情况以及一项医生参与策略的影响。

方法

开展了一项横断面调查,以评估医生参与策略对与EHR使用相关的职业倦怠的感知影响。邀请医生参与一项基于网络的调查,该调查包括Mini-Z职业倦怠问卷,以及关于他们对EHR的看法和医生参与策略中各项举措有效性的问题。运用描述性统计分析定量数据,同时使用主题分析处理定性数据。

结果

在受邀的254名医生中,128名完成了调查,回复率为50%。在受访者中,根据Mini-Z问卷,26%(33/128)符合职业倦怠标准,其中61%(20/33)将其职业倦怠归因于EHR的使用。约52%的参与者表示EHR改善了沟通(67/128),38%的人认为EHR有助于提供高质量护理(49/128)。关于医生参与策略举措,39%(50/128)的人认为通过该策略进行的沟通是有效的,75%(96/128)的人感觉在使用EHR方面更熟练。然而,也确定了EHR内需要改进的其他方面,包括:(1)用药核对和处方流程;(2)图表导航和信息检索;(3)纵向用药史;以及(4)技术基础设施挑战。

结论

本研究突出了EHR对医生职业倦怠的潜在影响,以及一项独特的医生参与策略在培养积极看法和提高医生对EHR可用性方面的有效性。通过在实际环境中评估这一举措,该研究为关于旨在提升大规模实施EHR后医生体验的策略的更广泛文献做出了贡献。然而,研究结果表明仍需进行系统层面的改进,以最大限度地提高EHR的价值和使用率。医生参与策略显示出提升医生EHR体验的潜力。未来的努力应优先考虑系统层面的进步,以增强EHR对护理质量的影响,并制定在更广泛的加拿大范围内让医生参与的标准化方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b97/12083741/1082da6def81/humanfactors-v12-e65656-g001.jpg

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