Adoption Factors of the Electronic Health Record: A Systematic Review.
Adoption Factors of the Electronic Health Record: A Systematic Review.
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DOI：
10.2196/medinform.5525
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发表时间：
2016-06-01
影响因子：
3.2
通讯作者：
Abanaka L
中科院分区：
文献类型：
--
作者：
Kruse CS;Kothman K;Anerobi K;Abanaka L
《卫生信息技术促进经济和临床卫生》(HITECH)是美国一项重要的立法，促进了卫生信息技术的采用。在HITECH法案实施后，卫生信息技术(HIT)经历了电子健康记录(EHR)的广泛采用，尽管许多供应商对过渡到电子系统表示怀疑。对电子健康记录采用的促进者和障碍的彻底审查为在各种医疗保健结构中继续实施电子健康记录提供了持续的支持，可能导致相关经济支出的减少。这项审查的目的是汇编一份当前全面的清单，列出在美国采用电子健康记录的促进者和障碍。作者检索CINAHL和MEDLINE，1/01/2012-09/01/2015，临床/学术核心期刊，MEDLINE全文，只评价与我们的研究目标相关的文章。小组成员通过协商一致会议(n=31)选出了最后的文章清单。多名研究团队成员仔细阅读每一篇文章，以确认适用性和研究结论，从而增加有效性。小组成员确定了与电子健康记录采用过程相关的共同促进者和障碍。文献中总共确定了25个采用促进者，共发生109次；其中大多数是效率、医院规模、质量、数据获取、感知价值和信息传输能力。文献中共确定了23个采用障碍，出现了95次；其中大部分是成本、耗时、无用感觉、数据转换、设施位置和实施问题。尽管HITECH法案有激励措施，但采用电子健康记录的25个促进者和23个障碍继续显示出对成本的关注。有限的资金支持和过时的技术也是在数据审查期间经常提到的常见障碍。未来的公共政策应该包括与HITECH法案中的激励措施相称的激励措施，以保持强劲的采用率。
The Health Information Technology for Economic and Clinical Health (HITECH) was a significant piece of legislation in America that served as a catalyst for the adoption of health information technology. Following implementation of the HITECH Act, Health Information Technology (HIT) experienced broad adoption of Electronic Health Records (EHR), despite skepticism exhibited by many providers for the transition to an electronic system. A thorough review of EHR adoption facilitator and barriers provides ongoing support for the continuation of EHR implementation across various health care structures, possibly leading to a reduction in associated economic expenditures. The purpose of this review is to compile a current and comprehensive list of facilitators and barriers to the adoption of the EHR in the United States. Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE, 01/01/2012–09/01/2015, core clinical/academic journals, MEDLINE full text, and evaluated only articles germane to our research objective. Team members selected a final list of articles through consensus meetings (n=31). Multiple research team members thoroughly read each article to confirm applicability and study conclusions, thereby increasing validity. Group members identified common facilitators and barriers associated with the EHR adoption process. In total, 25 adoption facilitators were identified in the literature occurring 109 times; the majority of which were efficiency, hospital size, quality, access to data, perceived value, and ability to transfer information. A total of 23 barriers to adoption were identified in the literature, appearing 95 times; the majority of which were cost, time consuming, perception of uselessness, transition of data, facility location, and implementation issues. The 25 facilitators and 23 barriers to the adoption of the EHR continue to reveal a preoccupation on cost, despite incentives in the HITECH Act. Limited financial backing and outdated technology were also common barriers frequently mentioned during data review. Future public policy should include incentives commensurate with those in the HITECH Act to maintain strong adoption rates.