临床医师对即时照护资讯资源的态度与认知,以及整合到电子健康档案:质性访谈研究。

IF 3.1 3区 医学 Q2 MEDICAL INFORMATICS
Marlika Marceau, Sevan Dulgarian, Jacob Cambre, Pamela M Garabedian, Mary G Amato, Diane L Seger, Lynn A Volk, Gretchen Purcell Jackson, David W Bates, Ronen Rozenblum, Ania Syrowatka
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引用次数: 0

摘要

背景:电子健康记录(EHRs)在美国的医疗保健系统中广泛使用,帮助临床医生在一个中心位置访问患者的病史。随着医学知识的扩展,临床医生越来越多地使用基于证据的护理点信息(POCI)资源来促进医疗实践中的临床决策。虽然这些工具可以改善临床结果,但很少有研究评估临床医生对将其与电子病历整合的意见。目的:本研究旨在评估临床医生对POCI资源在临床实践中寻找药物和疾病相关信息及其与电子病历整合的态度和感知价值。方法:在2021年12月至2022年1月期间,对马萨诸塞州波士顿布里格姆妇女医院的10名不同角色和专业的临床医生进行了半结构化访谈。使用内容分析方法来检查参与者对他们目前使用POCI资源、障碍和促进因素、移动应用程序使用以及改进集成的建议的反应和反馈。结果:在10名参与者中,6名(60%)是女性,9名(90%)是老年人。结论:参与者赞成整合,通过减少花费在寻找药物和疾病相关问题答案上的时间来提高可用性和优化工作效率。关于集成的建议强调了利益相关者在开发临床决策支持工具和界面方面的投入,这些工具和界面可以利用人工智能和机器学习的进步,同时不影响用户体验或增加任务花费的时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinician Attitudes and Perceptions of Point-of-Care Information Resources and Their Integration Into Electronic Health Records: Qualitative Interview Study.

Background: Electronic health records (EHRs) are widely used in health care systems across the United States to help clinicians access patient medical histories in one central location. As medical knowledge expands, clinicians are increasingly using evidence-based point-of-care information (POCI) resources to facilitate clinical decision-making in medical practices. While these tools can improve clinical outcomes, few studies have assessed clinicians' opinions on integrating them with EHRs.

Objective: This study aims to assess clinicians' attitudes and the perceived value of POCI resources for finding medication- and disease-related information in clinical practice and their integration with EHRs.

Methods: Semistructured interviews were conducted with 10 clinicians from various roles and specialties between December 2021 and January 2022 at Brigham and Women's Hospital in Boston, Massachusetts. A content analysis approach was used to examine participants' responses and feedback on their current use of POCI resources, barriers and facilitators, mobile app use, and recommendations for improved integration.

Results: Of the 10 participants, 6 (60%) were female, 9 (90%) were aged <40 years, and 8 (80%) had ≤10 years of experience in clinical practice. While UpToDate was the most preferred disease-related information resource (n=9, 90%), preferences for medication-related resources varied, with 2 (20%) participants favoring Micromedex, 2 (20%) favoring Lexicomp, 2 (20%) favoring Brigham and Women's Hospital-specific drug administration guidelines, 2 (20%) favoring UpToDate, and 1 (10%) favoring Medscape. Most participants used their preferred tools weekly. Most clinicians preferred comprehensive POCI tools with clear, navigable layouts that eased and quickened the search for information. Features such as heavy text density, the lack of citations, and frequent log-ins to access the tool were viewed as barriers that limited content legibility, credibility, and accessibility. Access-related, tool-specific, and integration-related barriers were reported to negatively impact clinical workflow. Most (n=8, 80%) of the participants reported currently using mobile apps, reasoning that they facilitated quick and convenient searches for information; however, frequent updates, time-consuming log-ins, and high text density on smaller screens posed challenges. Most participants favored further integration of POCI resources with EHRs, with all reporting them being currently available as embedded links that launch externally. Some recommended that further integration would allow us to leverage existing POCI tool features, such as chatbots and knowledge links, as well as aspects of artificial intelligence and machine learning, such as predictive algorithms and personalized alert systems, to enhance EHR functionality.

Conclusions: Participants favored integration to improve usability and optimize workplace efficiency by reducing the amount of time spent seeking answers to their medication- and disease-related questions. Recommendations on integration highlighted the need for stakeholder input in developing clinical decision support tools and interfaces that leverage advancements in artificial intelligence and machine learning while not compromising user experience or increasing time spent on tasks.

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来源期刊
JMIR Medical Informatics
JMIR Medical Informatics Medicine-Health Informatics
CiteScore
7.90
自引率
3.10%
发文量
173
审稿时长
12 weeks
期刊介绍: JMIR Medical Informatics (JMI, ISSN 2291-9694) is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. It has a focus on applied, translational research, with a broad readership including clinicians, CIOs, engineers, industry and health informatics professionals. Published by JMIR Publications, publisher of the Journal of Medical Internet Research (JMIR), the leading eHealth/mHealth journal (Impact Factor 2016: 5.175), JMIR Med Inform has a slightly different scope (emphasizing more on applications for clinicians and health professionals rather than consumers/citizens, which is the focus of JMIR), publishes even faster, and also allows papers which are more technical or more formative than what would be published in the Journal of Medical Internet Research.
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