Tarja Heponiemi, Lotta Virtanen, Emma Kainiemi, Petra Saukkonen, Jarmo Reponen, Tinja Lääveri
{"title":"卫生信息系统对管理和工作变化的支持:对医生的调查研究。","authors":"Tarja Heponiemi, Lotta Virtanen, Emma Kainiemi, Petra Saukkonen, Jarmo Reponen, Tinja Lääveri","doi":"10.2196/65913","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The digitalization of health care has advanced significantly in recent years. Consequently, physicians have needed to increasingly adopt new digital health technologies such as electronic health record systems and other health information systems. Digitalization has changed physicians' clinical work, work environment, management work, and use of tools for leadership. Many physician leaders have been critical of the capabilities of health information systems (HISs) to support leadership, management, and knowledge management.</p><p><strong>Objective: </strong>We aimed to examine the association between leadership position and perceived changes in clinical work due to digitalization among a nationally representative sample of Finnish physicians and physician leaders. In addition, we examined physician leaders' perceptions of HISs as a support for management and whether their opinions differed based on their perceptions on changes in clinical work due to digitalization.</p><p><strong>Methods: </strong>Altogether 4630 Finnish physicians (2960/4586, 64% women) responded to a cross-sectional nation-wide web-based survey conducted in spring 2021. Perceptions of improved preventive work, facilitated access to patient information, progressed interprofessional collaboration, and accelerated clinical encounters were used as measures of changes due to digitalization. First, we examined with multivariable logistic regression analyses whether being in a leadership position was associated with perceived changes in work due to digitalization (improved preventive work, facilitated access to patient information, progressed interprofessional collaboration, and accelerated clinical encounters in separate analyses) in the total sample. Second, we examined with analyses of covariance whether the variables related to perceived changes in work due to digitalization were associated with perceived management support from HISs among those who had administrative or management responsibilities (n=817). All analyses were adjusted for gender, age, and sector.</p><p><strong>Results: </strong>Physician leaders had greater odds of agreeing that digitalization had improved preventive work (odds ratio [OR] 1.62, 95% CI 1.33-1.98), facilitated access to patient information (OR 1.28, 95% CI 1.09-1.51), progressed interprofessional collaboration (OR 1.81, 95% CI 1.53-2.14), and accelerated clinical encounters (OR 1.31, 95% CI 1.01-1.70) than those in nonleadership positions. Furthermore, leaders who perceived these changes in work due to digitalization positively also considered that health information systems supported their management work.</p><p><strong>Conclusions: </strong>Physician leaders appeared to view the changes in work due to digitalization more positively than other physicians. In addition, those leaders who perceived these changes positively also perceived that HISs supported their management work. Thus, leaders should thoroughly evaluate and address physicians' perceptions of their routine clinical work and its evolving nature. Doing so ensures access to up-to-date and accurate insights, enabling more effective planning of staffing, training programs, and future implementations. Furthermore, our results show that to guarantee positive views about digitalization among physician leaders, information systems should also support managerial work. This highlights the need to focus on the quality, utility, and usability of information systems.</p>","PeriodicalId":56334,"journal":{"name":"JMIR Medical Informatics","volume":"13 ","pages":"e65913"},"PeriodicalIF":3.1000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health Information Systems' Support for Management and Changing Work: Survey Study Among Physicians.\",\"authors\":\"Tarja Heponiemi, Lotta Virtanen, Emma Kainiemi, Petra Saukkonen, Jarmo Reponen, Tinja Lääveri\",\"doi\":\"10.2196/65913\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The digitalization of health care has advanced significantly in recent years. Consequently, physicians have needed to increasingly adopt new digital health technologies such as electronic health record systems and other health information systems. Digitalization has changed physicians' clinical work, work environment, management work, and use of tools for leadership. Many physician leaders have been critical of the capabilities of health information systems (HISs) to support leadership, management, and knowledge management.</p><p><strong>Objective: </strong>We aimed to examine the association between leadership position and perceived changes in clinical work due to digitalization among a nationally representative sample of Finnish physicians and physician leaders. In addition, we examined physician leaders' perceptions of HISs as a support for management and whether their opinions differed based on their perceptions on changes in clinical work due to digitalization.</p><p><strong>Methods: </strong>Altogether 4630 Finnish physicians (2960/4586, 64% women) responded to a cross-sectional nation-wide web-based survey conducted in spring 2021. Perceptions of improved preventive work, facilitated access to patient information, progressed interprofessional collaboration, and accelerated clinical encounters were used as measures of changes due to digitalization. First, we examined with multivariable logistic regression analyses whether being in a leadership position was associated with perceived changes in work due to digitalization (improved preventive work, facilitated access to patient information, progressed interprofessional collaboration, and accelerated clinical encounters in separate analyses) in the total sample. Second, we examined with analyses of covariance whether the variables related to perceived changes in work due to digitalization were associated with perceived management support from HISs among those who had administrative or management responsibilities (n=817). All analyses were adjusted for gender, age, and sector.</p><p><strong>Results: </strong>Physician leaders had greater odds of agreeing that digitalization had improved preventive work (odds ratio [OR] 1.62, 95% CI 1.33-1.98), facilitated access to patient information (OR 1.28, 95% CI 1.09-1.51), progressed interprofessional collaboration (OR 1.81, 95% CI 1.53-2.14), and accelerated clinical encounters (OR 1.31, 95% CI 1.01-1.70) than those in nonleadership positions. Furthermore, leaders who perceived these changes in work due to digitalization positively also considered that health information systems supported their management work.</p><p><strong>Conclusions: </strong>Physician leaders appeared to view the changes in work due to digitalization more positively than other physicians. In addition, those leaders who perceived these changes positively also perceived that HISs supported their management work. Thus, leaders should thoroughly evaluate and address physicians' perceptions of their routine clinical work and its evolving nature. Doing so ensures access to up-to-date and accurate insights, enabling more effective planning of staffing, training programs, and future implementations. Furthermore, our results show that to guarantee positive views about digitalization among physician leaders, information systems should also support managerial work. This highlights the need to focus on the quality, utility, and usability of information systems.</p>\",\"PeriodicalId\":56334,\"journal\":{\"name\":\"JMIR Medical Informatics\",\"volume\":\"13 \",\"pages\":\"e65913\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JMIR Medical Informatics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2196/65913\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICAL INFORMATICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR Medical Informatics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2196/65913","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICAL INFORMATICS","Score":null,"Total":0}
引用次数: 0
摘要
背景:近年来,医疗保健数字化取得了显著进展。因此,医生需要越来越多地采用新的数字健康技术,如电子健康记录系统和其他健康信息系统。数字化改变了医生的临床工作、工作环境、管理工作以及领导工具的使用。许多医生领导对卫生信息系统(HISs)支持领导、管理和知识管理的能力持批评态度。目的:我们旨在研究芬兰医生和医生领导的全国代表性样本中,由于数字化,领导地位和临床工作感知变化之间的关系。此外,我们调查了医生领导对HISs作为管理支持的看法,以及他们对数字化导致的临床工作变化的看法是否有所不同。方法:共有4630名芬兰医生(2960/4586,64%的女性)参与了2021年春季进行的一项全国性的基于网络的横断面调查。改善预防工作、促进患者信息获取、推进跨专业合作和加速临床接触的感知被用作数字化带来的变化的衡量标准。首先,我们通过多变量逻辑回归分析检验了在整个样本中,领导职位是否与数字化(改善预防工作,促进患者信息获取,推进跨专业合作,加速单独分析中的临床接触)所带来的工作变化相关。其次,我们通过协方差分析检验了在那些有行政或管理职责的人(n=817)中,与数字化导致的感知工作变化相关的变量是否与感知来自HISs的管理支持相关。所有的分析都根据性别、年龄和行业进行了调整。结果:与非领导职位的医生相比,医生领导更有可能同意数字化改善了预防工作(比值比[OR] 1.62, 95% CI 1.33-1.98),促进了患者信息的获取(比值比[OR] 1.28, 95% CI 1.09-1.51),促进了跨专业合作(比值比[OR] 1.81, 95% CI 1.53-2.14),并加速了临床接触(比值比[OR] 1.31, 95% CI 1.01-1.70)。此外,积极看待数字化带来的这些工作变化的领导者也认为卫生信息系统支持了他们的管理工作。结论:医生领导似乎比其他医生更积极地看待数字化带来的工作变化。此外,那些积极看待这些变化的领导者也认为HISs支持他们的管理工作。因此,领导者应该彻底评估和解决医生对其日常临床工作及其不断发展的性质的看法。这样做可以确保获得最新和准确的见解,从而实现更有效的人员配置、培训计划和未来实施计划。此外,我们的研究结果表明,为了保证医师领导对数字化的积极看法,信息系统也应该支持管理工作。这突出了关注信息系统的质量、效用和可用性的需要。
Health Information Systems' Support for Management and Changing Work: Survey Study Among Physicians.
Background: The digitalization of health care has advanced significantly in recent years. Consequently, physicians have needed to increasingly adopt new digital health technologies such as electronic health record systems and other health information systems. Digitalization has changed physicians' clinical work, work environment, management work, and use of tools for leadership. Many physician leaders have been critical of the capabilities of health information systems (HISs) to support leadership, management, and knowledge management.
Objective: We aimed to examine the association between leadership position and perceived changes in clinical work due to digitalization among a nationally representative sample of Finnish physicians and physician leaders. In addition, we examined physician leaders' perceptions of HISs as a support for management and whether their opinions differed based on their perceptions on changes in clinical work due to digitalization.
Methods: Altogether 4630 Finnish physicians (2960/4586, 64% women) responded to a cross-sectional nation-wide web-based survey conducted in spring 2021. Perceptions of improved preventive work, facilitated access to patient information, progressed interprofessional collaboration, and accelerated clinical encounters were used as measures of changes due to digitalization. First, we examined with multivariable logistic regression analyses whether being in a leadership position was associated with perceived changes in work due to digitalization (improved preventive work, facilitated access to patient information, progressed interprofessional collaboration, and accelerated clinical encounters in separate analyses) in the total sample. Second, we examined with analyses of covariance whether the variables related to perceived changes in work due to digitalization were associated with perceived management support from HISs among those who had administrative or management responsibilities (n=817). All analyses were adjusted for gender, age, and sector.
Results: Physician leaders had greater odds of agreeing that digitalization had improved preventive work (odds ratio [OR] 1.62, 95% CI 1.33-1.98), facilitated access to patient information (OR 1.28, 95% CI 1.09-1.51), progressed interprofessional collaboration (OR 1.81, 95% CI 1.53-2.14), and accelerated clinical encounters (OR 1.31, 95% CI 1.01-1.70) than those in nonleadership positions. Furthermore, leaders who perceived these changes in work due to digitalization positively also considered that health information systems supported their management work.
Conclusions: Physician leaders appeared to view the changes in work due to digitalization more positively than other physicians. In addition, those leaders who perceived these changes positively also perceived that HISs supported their management work. Thus, leaders should thoroughly evaluate and address physicians' perceptions of their routine clinical work and its evolving nature. Doing so ensures access to up-to-date and accurate insights, enabling more effective planning of staffing, training programs, and future implementations. Furthermore, our results show that to guarantee positive views about digitalization among physician leaders, information systems should also support managerial work. This highlights the need to focus on the quality, utility, and usability of information systems.
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.