Physician Beliefs about the Meaningful Use of the Electronic Health Record: A Follow-Up Study
Physician Beliefs about the Meaningful Use of the Electronic Health Record: A Follow-Up Study
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DOI：
10.4338/aci-2017-05-ra-0079
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发表时间：
2017-01-01
影响因子：
2.9
通讯作者：
Bates, David W.
中科院分区：
文献类型：
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作者：
Emani, Srinivas;Ting, David Y.;Bates, David W.
背景医生如何对电子健康记录(EHR)激励计划的有意义的使用做出反应一直是人们感兴趣的问题。本研究旨在对医生对电子健康记录有意义使用的信念进行跟踪研究。方法对东北地区两个学术医疗中心的医生进行在线调查，调查对象为有意义地使用电子健康记录激励计划的医生和使用自行开发的电子健康记录的医生。只有五分之一(20.5%)的医生同意或强烈同意有意义地使用电子健康记录将帮助他们改善医疗质量，只有四分之一(25.2%)同意或强烈同意有意义地使用电子健康记录将改善他们组织提供的医疗服务。医生对门诊患者电子病历的满意度是实现电子病历激励计划第二阶段有意义使用的自我效能的最强预测因子(优势比：2.1，95%可信区间：1.61，2.75，p<；0.001)。医生报告说，在所有信仰项目中，阶段2的负面信念比阶段1更多。例如，28.1%的医生同意或强烈同意有意义地使用电子病历将减少第二阶段的医疗差错，而第一阶段的这一比例为35.9%(p<；0.001)。结论在我们的研究中，只有五分之一的医生认为有意义地使用电子病历将改善医疗质量、以患者为中心的医疗服务或他们个人提供的医疗服务。初级保健医生在第二阶段比第一阶段对电子健康记录的有意义的使用表现出更多的负面信念。这些发现表明医生继续对电子健康记录的有意义的使用表示消极的信念。这些持续不断的负面信念既关系到执行，也关系到政策。
Background There is continuing interest in how physicians are responding to the meaningful use of the electronic health record (EHR) incentive program. However, little research has been done on physician beliefs about the meaningful use of the EHR.Objective This study aims to conduct a follow-up study of physician beliefs about the meaningful use of the EHR.Methods Online survey of physicians at two academic medical centers (AMCs) in the northeast who were participating in the meaningful use of the EHR incentive program and were using an internally developed EHR was conducted.Results Of the 2,033 physicians surveyed, 1,075 completed the survey for an overall response rate of 52.9%. Only one-fifth (20.5%) of the physicians agreed or strongly agreed that meaningful use of the EHR would help them improve quality of care, and only a quarter (25.2%) agreed or strongly agreed that the meaningful use of the EHR would improve the care that their organization delivers. Physician satisfaction with the outpatient EHR was the strongest predictor of self-efficacy with achieving stage 2 of the meaningful use of the EHR incentive program (odds ratio: 2.10, 95% confidence interval: 1.61, 2.75, p < 0.001). Physicians reported more negative beliefs in stage 2 than stage 1 across all belief items. For example, 28.1% agreed or strongly agreed that the meaningful use of the EHR would decrease medical errors in stage 2 as compared with 35.9% in stage 1 (p < 0.001).Conclusion Only one-fifth of the physicians in our study believed that the meaningful use of the EHR would improve quality of care, patient-centeredness of care, or the care they personally provide. Primary care physicians expressedmore negative beliefs about the meaningful use of the EHR in stage 2 than in stage 1. These findings show that physicians continue to express negative beliefs about the meaningful use of the EHR. These ongoing negative beliefs are concerning for both implementation and policy.