A study of general practitioners' perspectives on electronic medical records systems in NHSScotland
A study of general practitioners' perspectives on electronic medical records systems in NHSScotland
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DOI：
10.1186/1472-6947-13-58
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发表时间：
2013-05-21
影响因子：
3.5
通讯作者：
Mair, Frances S.
中科院分区：
文献类型：
--
作者：
Bouamrane, Matt-Mouley;Mair, Frances S.
背景：苏格兰 NHSS 的初级保健医生多年来一直在其实践中常规使用电子病历。苏格兰卫生行政部门的电子医疗战略（2008-2011）最近给苏格兰的初级保健计算环境带来了根本性的变化：由 NHSScotland 免费向大多数全科医生诊所提供的信息系统 (GPASS) 现在已被两家经批准的商业提供商提供的系统所取代。到 2012 年 3 月，全国所有卫生委员会必须完成向新电子病历的过渡。 方法：我们对初级保健医生进行了 25 次深入的半结构化访谈，以阐明全科医生对其执业信息系统的看法，并收集有关苏格兰 NHSS 患者手术路径管理流程的更多一般信息。我们使用规范化过程理论作为基础概念框架，对受访者的回答进行了主题分析。 结果：大多数受访的全科医生认为电子病历是其咨询工作中不可或缺的重要组成部分，在促进患者护理的综合性和连续性以及使临床信息更容易获取方面发挥着关键作用。然而，全科医生对各种系统功能表示了一些保留意见，例如：在可用性、系统导航和信息可视化方面。结论：我们的研究强调，虽然电子信息系统被认为具有重要的好处，但仍有很大的空间来改善全科医生对这些系统的交互和总体满意度。以用户为中心的迭代改进与技术使用方面的额外培训相结合，将促进初级保健医生对电子病历一系列功能的理解、熟悉和掌握。
Background: Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012.Methods: We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs' perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees' responses, using Normalisation Process Theory as the underpinning conceptual framework.Results: The majority of GPs' interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities - for example: in relation to usability, system navigation and information visualisation.Conclusion: Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs' interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors.