Ash J S
Biomedical Information Communication Center, Oregon Health Sciences University, Portland 97201-3098, USA.
Proc AMIA Annu Fall Symp. 1997:682-6.
A survey of the perceptions of 629 informatics experts representing 67 institutions with accredited schools of medicine was used to identify factors most important in implementing the Computer-Based Patient Record. A model outlined three theoretical factors: Innovation Attributes (attributes inherent in the CPR itself); Organizational Attributes; and Boundary-Spanning Attributes (related to marketing efforts). The model was explored using multiple regression techniques to delineate the relative importance of 15 variables within the three sets of factors and their effect on two measures of diffusion. The two dependent variables were internal diffusion, or spread of usage of the CPR, and infusion, or depth of usage. Data from the 144 respondents indicate that for diffusion, the organizational variables of "decision making" and "planning" had a significant impact, although the relation between "planning" and diffusion was negative. For infusion, the Innovation Attributes variable "visibility" was significant. The major implication is that successfully encouraging usage of the CPR entails attention and resources devoted to managing the organizational aspects of implementation.
一项针对代表67所拥有经认可医学院校的机构的629位信息学专家的认知调查，被用于确定在实施基于计算机的患者记录中最重要的因素。一个模型概述了三个理论因素：创新属性（CPR本身固有的属性）；组织属性；以及跨界属性（与营销努力相关）。使用多元回归技术对该模型进行探索，以描绘三组因素中15个变量的相对重要性及其对两种传播度量的影响。两个因变量分别是内部传播，即CPR使用的传播，以及注入，即使用的深度。来自144位受访者的数据表明，对于传播而言，“决策制定”和“规划”这两个组织变量具有显著影响，尽管“规划”与传播之间的关系为负。对于注入而言，创新属性变量“可见性”具有显著性。主要的启示是，成功鼓励CPR的使用需要关注并投入资源来管理实施的组织方面。
