Martha Snow, Wagner Silva-Ribeiro, Mary Baginsky, Sonya Di Giorgio, Nicola Farrelly, Cath Larkins, Karen Poole, Nicole Steils, Joanne Westwood, Juliette Malley
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引用次数: 0
Abstract
Background: In the past decade, the use of digital or electronic records in social care has risen worldwide, capturing key information for service delivery. The COVID-19 pandemic accelerated digitization in health and social care. For example, the UK government created a fund specifically for adult social care provider organizations to adopt digital social care records. These developments offer valuable learning opportunities for implementing digital care records in adult social care settings.
Objective: This rapid scoping review aimed to understand what is known about the implementation of digital care records in adult social care and how implementation varies across use cases, settings, and broader contexts.
Methods: A scoping review methodology was used, with amendments made to enable a rapid review. Comprehensive searches based on the concepts of digital care records, social care, and interoperability were conducted across the MEDLINE, EmCare, Web of Science Core Collection, HMIC Health Management Information Consortium, Social Policy and Practice, and Social Services Abstracts databases. Studies published between 2018 and 2023 in English were included. One reviewer screened titles and abstracts, while 2 reviewers extracted data. Thematic analysis mapped findings against the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework.
Results: Our search identified 2499 references. After screening titles and abstracts, 71 records were selected for full-text review, resulting in 31 references from 29 studies. Studies originated from 11 countries, including 1 multicountry study, with the United Kingdom being the most represented (10/29, 34%). Studies were most often conducted in nursing homes or facilities (7/29, 24%) with older people as the target population (6/29, 21%). Health records were the most investigated record type (12/29, 41%). We identified 45 facilitators and 102 barriers to digital care record implementation across 28 studies, spanning 6 of the 7 NASSS framework domains and aligning with 5 overarching themes that require greater active management regarding implementation. Intended or actual implementation outcomes were reported in 17 (59%) of the 29 studies.
Conclusions: The findings suggest that implementation is complex due to a lack of consensus on what digital care records and expected outcomes and impacts should look like. The literature often lacks clear definitions and robust study designs. To be successful, implementation should consider complexity, while studies should use robust frameworks and mixed methods or quantitative designs where appropriate. Future research should define the target population, gather data on carer or service user experiences, and focus on digital care records specifically used in social care.
背景:在过去十年中,在世界范围内,在社会护理中使用数字或电子记录的情况有所增加,为服务提供提供关键信息。2019冠状病毒病大流行加速了卫生和社会保健领域的数字化。例如,英国政府专门为成人社会保健提供者组织设立了一个基金,以采用数字社会保健记录。这些发展为在成人社会护理环境中实施数字护理记录提供了宝贵的学习机会。目的:这个快速的范围审查旨在了解成人社会护理中数字护理记录的实施情况,以及在不同的用例、设置和更广泛的背景下,实施情况如何变化。方法:采用范围审查方法学,并对其进行修改,以便快速审查。在MEDLINE、EmCare、Web of Science核心馆藏、HMIC健康管理信息联盟、社会政策与实践和社会服务摘要数据库中进行了基于数字医疗记录、社会护理和互操作性概念的综合搜索。纳入了2018年至2023年间发表的英文研究。1名审稿人筛选标题和摘要,2名审稿人提取数据。专题分析针对不采用、放弃、扩大规模、推广和可持续性(NASSS)框架绘制了调查结果。结果:检索到2499篇参考文献。筛选标题和摘要后,选取71篇文献进行全文综述,29篇研究共纳入31篇参考文献。研究来自11个国家,包括1项多国研究,其中英国的代表性最大(10/29,34%)。研究最常在养老院或设施中进行(7/ 29,24%),老年人作为目标人群(6/ 29,21%)。健康记录是被调查最多的记录类型(12/29,41%)。我们在28项研究中确定了数字医疗记录实施的45个促进因素和102个障碍,涵盖了7个NASSS框架领域中的6个,并与5个总体主题保持一致,这些主题在实施方面需要更积极的管理。在29项研究中,有17项(59%)报告了预期或实际的实施结果。结论:研究结果表明,由于对数字护理记录和预期结果和影响缺乏共识,实施起来很复杂。文献通常缺乏明确的定义和健全的研究设计。为了取得成功,实施应考虑复杂性,而研究应在适当情况下使用健全的框架和混合方法或定量设计。未来的研究应明确目标人群,收集护理或服务用户体验的数据,并将重点放在专门用于社会护理的数字护理记录上。