Structured Data Entry in the Electronic Medical Record: Perspectives of Pediatric Specialty Physicians and Surgeons

被引:35
作者
Bush, Ruth A. [1 ,2 ]
Kuelbs, Cynthia [3 ]
Ryu, Julie [3 ]
Jiang, Wen [4 ]
Chiang, George [5 ]
机构
[1] Univ San Diego, Beyster Inst Nursing Res, San Diego, CA 92110 USA
[2] Rady Childrens Hosp, Clin Informat, San Diego, CA 92123 USA
[3] Univ Calif San Diego, Dept Pediat, San Diego, CA 92103 USA
[4] Univ Calif San Diego, Dept Surg, San Diego, CA 92103 USA
[5] Rady Childrens Inst Genom Med, San Diego, CA USA
基金
美国医疗保健研究与质量局;
关键词
Electronic health records; Health information technology; Pediatrics; Physicians; Survey; INFORMATION-TECHNOLOGY; USER ACCEPTANCE; SYSTEMS;
D O I
10.1007/s10916-017-0716-5
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
100404 [儿少卫生与妇幼保健学];
摘要
The Epic electronic health record (EHR) platform supports structured data entry systems (SDES), which allow developers, with input from users, to create highly customized patient-record templates in order to maximize data completeness and to standardize structure. There are many potential advantages of using discrete data fields in the EHR to capture data for secondary analysis and epidemiological research, but direct data acquisition from clinicians remains one of the largest obstacles to leveraging the EHR for secondary use. Physician resistance to SDES ismultifactorial. A 35-item questionnaire based on Unified Theory of Acceptance and Use of Technology, was used to measure attitudes, facilitation, and potential incentives for adopting SDES for clinical documentation among 25 pediatric specialty physicians and surgeons. Statistical analysis included chi-square for categorical data as well as independent sample t-tests and analysis of variance for continuous variables. Mean scores of the nine constructs demonstrated primarily positive physician attitudes toward SDES, while the surgeons were neutral. Those under 40 were more likely to respond that facilitating conditions for structured entry existed as compared to the two older age groups (p =.02). Pediatric surgeons were significantly less positive than specialty physicians about SDES effects on Performance (p =.01) and the effect of Social Influence (p =.02); but in more agreement that use of forms was voluntary (p =.02). Attitudinal differences likely reflect medical training, clinical practice workflows, and division specific practices. Identified resistance indicate efforts to increase SDES adoption should be discipline-targeted rather than a uniform approach.
引用
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页数:8
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