Schwappach David, Hautz Wolf, Krummrey Gert, Pfeiffer Yvonne, Ratwani Raj M
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Department of Emergency Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland.
NPJ Digit Med. 2025 May 15;8(1):282. doi: 10.1038/s41746-025-01657-4.
Despite widespread adoption of electronic medical records (EMRs), concerns persist regarding their usability and implications for patient safety. This national cross-sectional survey assessed physicians' perceptions of EMR usability across safety-relevant domains. Among 1933 respondents from diverse care settings, 56% reported that their EMR did not enhance patient safety, and 50% perceived their system as inefficient. Usability ratings averaged 52% of the maximum score. Statistically significant differences were observed between EMRs in outpatient (η² = 0.13) and hospital (η² = 0.37) settings. Multilevel modeling attributed 38% of the variance in usability ratings to differences between EMRs, 51% to hospital-level variation within EMRs, and 11% to physician-level differences. Canonical discriminant analysis identified key differentiating usability features, including system response times, excessive alerts, prevention of data entry errors, and support for collaboration. These findings underscore substantial limitations in current EMR systems and reinforce the value of comparative usability assessments to inform targeted improvements in digital health infrastructure.
尽管电子病历（EMR）已得到广泛应用，但人们对其可用性以及对患者安全的影响仍存在担忧。这项全国性横断面调查评估了医生对电子病历在与安全相关领域可用性的看法。在来自不同护理环境的1933名受访者中，56%报告称他们的电子病历并未提高患者安全性，50%认为他们的系统效率低下。可用性评分平均为满分的52%。门诊电子病历（η² = 0.13）和医院电子病历（η² = 0.37）之间存在统计学上的显著差异。多层次建模将可用性评分差异的38%归因于电子病历之间的差异，51%归因于电子病历内医院层面的差异，11%归因于医生层面的差异。典型判别分析确定了关键的区分可用性特征，包括系统响应时间、过多警报、防止数据输入错误以及对协作的支持。这些发现凸显了当前电子病历系统存在的重大局限性，并强化了比较可用性评估对指导数字健康基础设施针对性改进的价值。
