Resistance Is Futile: But It Is Slowing the Pace of EHR Adoption Nonetheless
Resistance Is Futile: But It Is Slowing the Pace of EHR Adoption Nonetheless
复制标题
DOI：
10.1197/jamia.m3042
复制
发表时间：
2009-05-01
影响因子：
6.4
通讯作者：
Huerta, Timothy R.
中科院分区：
文献类型：
--
作者：
Ford, Eric W.;Menachemi, Nir;Huerta, Timothy R.
目的：本研究的目的是重新评估电子健康记录（EHR）扩散的预计速度，并研究如何联邦政府的努力，以促进使用EHR技术影响医生的意愿，采用这种系统。该研究重新创建并扩展了福特等人进行的分析。(1)这两个时期的研究之前和之后，美国联邦政府的协调一致的活动，以促进EHR administration.Design：元分析和低音建模被用来比较EHR的扩散率为两个不同时期的政府活动。在2004年之前的第一个时期，政府在推广电子健康记录方面的活动水平很低。在2004年，美国总统呼吁到2014年（10年）的“普及EHR采用”，创建活动的主要浪潮和EHR将如何影响医生的practices.Measurement提高认识：EHR采用参数外部和内部的影响系数估计使用低音扩散模型和未来的采用率进行预测。结果如下：比较2004年前后（分别为2001-2004年和2001-2007年）的电子健康记录采用率，表明医生对采用的阻力在第二个时期有所增加。根据目前的采用水平，不到一半的医生在小的做法将实施EHR到2014年（47.3%）。结论：驱动EHR扩散的外部力量已经增长的重要性，自2004年以来，相对于医生的内部动机，采用这种系统。几个国家的力量可能有助于减缓EHR传播的速度。美国医学信息协会杂志2009;16：274-281。DOI 10.1197/jamia.M3042.
Objective: The purpose of this study is to reassess the projected rate of Electronic Health Record (EHR) diffusion and examine how the federal government's efforts to promote the use of EHR technology have influenced physicians' willingness to adopt such systems. The study recreates and extends the analyses conducted by Ford et al.(1) The two periods examined come before and after the U.S. Federal Government's concerted activity to promote EHR adoption.Design: Meta-analysis and bass modeling are used to compare EHR diffusion rates for two distinct periods of government activity. Very low levels of government activity to promote EHR diffusion marked the first period, before 2004. In 2004, the President of the United States called for a "Universal EHR Adoption" by 2014 (10 yrs), creating the major wave of activity and increased awareness of how EHRs will impact physicians' practices.Measurement: EHR adoption parameters-external and internal coefficients of influence-are estimated using bass diffusion models and future adoption rates are projected. Results: Comparing the EHR adoption rates before and after 2004 (2001-2004 and 2001-2007 respectively) indicate the physicians' resistance to adoption has increased during the second period. Based on Current levels of adoption, less than half the physicians working in small practices will have implemented an EHR by 2014 (47.3%).Conclusions: The external forces driving EHR diffusion have grown in importance since 2004 relative to physicians' internal motivation to adopt such systems. Several national forces are likely contributing to the slowing pace of EHR diffusion. J Am Med Inform Assoc. 2009;16:274-281. DOI 10.1197/jamia.M3042.