Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review.
Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review.
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DOI：
10.1186/1741-7015-9-46
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发表时间：
2011-04-28
期刊：
影响因子：
9.3
通讯作者：
Gagnon MP
中科院分区：
文献类型：
--
作者：
McGinn CA;Grenier S;Duplantie J;Shaw N;Sicotte C;Mathieu L;Leduc Y;Légaré F;Gagnon MP
与许多其他国家一样，加拿大目前正在实施电子健康记录（EHR）。这些雄心勃勃的项目涉及许多对执行过程有独特看法的利益攸关方。EHR用户扮演着重要的角色，因为他们必须将EHR系统集成到他们的工作环境中，并在日常活动中使用它。用户掌握着宝贵的第一手知识，了解什么会限制或有助于EHR实施项目的成功。全面综合EHR用户的看法是未来成功实施的关键。这一系统的文献综述的目的是综合目前的知识的障碍和促进者影响共享EHR的实施之间的各种用户。在1999年至2009年期间，对9个电子数据库进行了文献检索。研究包括，如果他们报告用户的感知障碍和促进者共享EHR实施，在医疗保健设置可比加拿大。包括所有语言的研究与实证研究设计。对研究的质量和相关性进行了评估。四个EHR用户组的目标：医生，其他医疗保健专业人员，管理人员和患者/公众。内容分析由两名作者独立进行，使用一个经过验证的提取网格与预先建立的分类的障碍和促进者为每组EHR用户。在识别的总共5，695篇潜在相关出版物中，筛选标题和摘要后获得了117篇全文出版物。在对全文进行审查后，60篇出版物（对应于52项研究）符合纳入标准。所有用户组最常见的采用因素是设计和技术问题，易用性，互操作性，隐私和安全性，成本，生产力，熟悉和使用EHR的能力，使用EHR的动机，患者和健康专业人员的互动，以及缺乏时间和工作量。每个用户群体还确定了其专业和个人优先事项的具体因素。这一系统的审查提出了创新性的研究的障碍和促进EHR的实施。虽然强调了用户群体之间的重要相似之处，但它们之间的差异表明，每个用户群体对执行过程也有独特的看法，应予以考虑。
Electronic health record (EHR) implementation is currently underway in Canada, as in many other countries. These ambitious projects involve many stakeholders with unique perceptions of the implementation process. EHR users have an important role to play as they must integrate the EHR system into their work environments and use it in their everyday activities. Users hold valuable, first-hand knowledge of what can limit or contribute to the success of EHR implementation projects. A comprehensive synthesis of EHR users' perceptions is key to successful future implementation. This systematic literature review was aimed to synthesize current knowledge of the barriers and facilitators influencing shared EHR implementation among its various users. Covering a period from 1999 to 2009, a literature search was conducted on nine electronic databases. Studies were included if they reported on users' perceived barriers and facilitators to shared EHR implementation, in healthcare settings comparable to Canada. Studies in all languages with an empirical study design were included. Quality and relevance of the studies were assessed. Four EHR user groups were targeted: physicians, other health care professionals, managers, and patients/public. Content analysis was performed independently by two authors using a validated extraction grid with pre-established categorization of barriers and facilitators for each group of EHR users. Of a total of 5,695 potentially relevant publications identified, 117 full text publications were obtained after screening titles and abstracts. After review of the full articles, 60 publications, corresponding to 52 studies, met the inclusion criteria. The most frequent adoption factors common to all user groups were design and technical concerns, ease of use, interoperability, privacy and security, costs, productivity, familiarity and ability with EHR, motivation to use EHR, patient and health professional interaction, and lack of time and workload. Each user group also identified factors specific to their professional and individual priorities. This systematic review presents innovative research on the barriers and facilitators to EHR implementation. While important similarities between user groups are highlighted, differences between them demonstrate that each user group also has a unique perspective of the implementation process that should be taken into account.
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