Appl Clin Inform - Electronic Health Record Adoption - Maybe It's not about the Money: Physician Super-Users, Electronic Health Records and Patient Care.

Tópicos

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{ care(1570) inform(1187) nurs(1089) }
{ use(2086) technolog(871) perceiv(783) }
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{ age(1611) year(1155) adult(843) }
{ sampl(1606) size(1419) use(1276) }
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{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
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{ detect(2391) sensit(1101) algorithm(908) }

Resumo

JECTIVE: The slow adoption of electronic health record (EHR) systems has been linked to physician resistance to change and the expense of EHR adoption. This qualitative study was conducted to evaluate benefits, and clarify limitations of two mature, robust, comprehensive EHR Systems by tech-savvy physicians where resistance and expense are not at issue.METHODS: Two EHR systems were examined - the paperless VistA / Computerized Patient Record System used at the Veterans' Administration, and the General Electric Centricity Enterprise system used at an academic medical center. A series of interviews was conducted with 20 EHR-savvy multiinstitutional internal medicine (IM) faculty and house staff. Grounded theory was used to analyze the transcribed data and build themes. The relevance and importance of themes were constructed by examining their frequency, convergence, and intensity.RESULTS: Despite eliminating resistance to both adoption and technology as drivers of acceptance, these two robust EHR's are still viewed as having an adverse impact on two aspects of patient care, physician workflow and team communication. Both EHR's had perceived strengths but also significant limitations and neither were able to satisfactorily address all of the physicians' needs.CONCLUSION: Difficulties related to physician acceptance reflect real concerns about EHR impact on patient care. Physicians are optimistic about the future benefits of EHR systems, but are frustrated with the non-intuitive interfaces and cumbersome data searches of existing EHRs.

Resumo Limpo

jectiv slow adopt electron health record ehr system link physician resist chang expens ehr adopt qualit studi conduct evalu benefit clarifi limit two matur robust comprehens ehr system techsavvi physician resist expens issuemethod two ehr system examin paperless vista computer patient record system use veteran administr general electr centric enterpris system use academ medic center seri interview conduct ehrsavvi multiinstitut intern medicin im faculti hous staff ground theori use analyz transcrib data build theme relev import theme construct examin frequenc converg intensityresult despit elimin resist adopt technolog driver accept two robust ehr still view advers impact two aspect patient care physician workflow team communic ehr perceiv strength also signific limit neither abl satisfactorili address physician needsconclus difficulti relat physician accept reflect real concern ehr impact patient care physician optimist futur benefit ehr system frustrat nonintuit interfac cumbersom data search exist ehr

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