Int J Med Inform - A study of user requests regarding the fully electronic health record system at Seoul National University Bundang Hospital: challenges for future electronic health record systems.

Tópicos

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Resumo

JECTIVE: Although the adoption rates for Electronic Health Records (EHRs) are growing, significant opportunities for further advances in EHR system design remain. The goal of this study was to identify issues that should be considered in the design process for the successful development of future systems by analyzing end users' service requests gathered during a recent three-year period after a comprehensive EHR system was implemented at Seoul National University's Bundang Hospital in South Korea.METHODS: Data on 11,400 service requests from end users of the EHR system made from 2008 through 2010 were used in this study. The requests were categorized as program modification/development, data request, insurance-fee identification/generation, patient-record merging, or other. The authors further subcategorized the requests for program modification/development into the following nine areas of concern: (1) indicators and statistics, (2) patient safety and quality of care, (3) special task-oriented functionalities, (4) ease of use and user interface, (5) system speed, (6) interoperability and integration, (7) privacy and security, (8) customer service, and (9) miscellaneous. The system users were divided into four groups--direct care, care support, administrative/insurance, and general management--to identify each group's needs and concerns.RESULTS: The service requests for program modification/development, data request, insurance-fee identification/generation, patient-record merging, and other issues constituted approximately 49.2%, 33.9%, 11.4%, 4.0%, and 1.5% of the total data set, respectively. The number of data-request service requests grew over the three years studied. Different groups of users were found to have different concerns according to their activities and tasks. Within the program-modification/development category, end users were most frequently concerned with ease of use and user interface (38.1% of the total) and special task-oriented functionalities (29.3% of the total) in their use of the EHR system, with increasing numbers of requests in both categories over the three years. Users in the direct-care group differed from the other groups in that they most frequently submitted requests related to ease of use and user interface, followed by special functionalities, patient safety and quality care, and customer service, while users in other groups submitted requests concerning ease of use and user interface and special functionalities with a similarly high frequency.CONCLUSIONS: Users have continued to make suggestions about their needs and requirements, and the EHR system has evolved to optimize ease of use and special functionalities for particular groups of users and particular subspecialties. Based on our experiences and the lessons we have learned in the course of maintaining full-EHR systems, we suggest that the key goals to be considered for future EHR systems include innovative new user-interface technologies; special extended functions for each user group's specific task-oriented requirements; powerful, easy-to-use functions to support research; new flexible system architecture; and patient-directed functions.

Resumo Limpo

jectiv although adopt rate electron health record ehr grow signific opportun advanc ehr system design remain goal studi identifi issu consid design process success develop futur system analyz end user servic request gather recent threeyear period comprehens ehr system implement seoul nation univers bundang hospit south koreamethod data servic request end user ehr system made use studi request categor program modificationdevelop data request insurancefe identificationgener patientrecord merg author subcategor request program modificationdevelop follow nine area concern indic statist patient safeti qualiti care special taskori function eas use user interfac system speed interoper integr privaci secur custom servic miscellan system user divid four groupsdirect care care support administrativeinsur general managementto identifi group need concernsresult servic request program modificationdevelop data request insurancefe identificationgener patientrecord merg issu constitut approxim total data set respect number datarequest servic request grew three year studi differ group user found differ concern accord activ task within programmodificationdevelop categori end user frequent concern eas use user interfac total special taskori function total use ehr system increas number request categori three year user directcar group differ group frequent submit request relat eas use user interfac follow special function patient safeti qualiti care custom servic user group submit request concern eas use user interfac special function similar high frequencyconclus user continu make suggest need requir ehr system evolv optim eas use special function particular group user particular subspecialti base experi lesson learn cours maintain fullehr system suggest key goal consid futur ehr system includ innov new userinterfac technolog special extend function user group specif taskori requir power easytous function support research new flexibl system architectur patientdirect function

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