Health Care Professionals’ Perspectives on Implementing Patient-Accessible Electronic Health Records in Primary Care: Qualitative Study
Notice bibliographique
Résumé
BACKGROUND: Patients are increasingly being offered online record access (ORA) through patient-accessible electronic health records (PAEHRs), but implementation is often met with resistance from health care professionals (HCPs). Experiences from previous implementations may provide important insights into potential barriers and facilitators. OBJECTIVE: This study aimed to investigate the factors influencing the implementation of the Swedish PAEHR system in primary care from the perspectives of HCPs. METHODS: We conducted 14 semistructured interviews with a diverse group of HCPs shortly after the implementation of the Swedish PAEHR system. The interviews were analyzed using the Consolidated Framework for Implementation Research (CFIR) and content analysis, identifying key themes related to PAEHR implementation. RESULTS: The analysis identified several potential factors influencing the implementation of the Swedish PAEHR system. According to the HCPs, the PAEHR system was flawed but also flexible. The HCPs described working in a complex and imperfect organization, which nonetheless had an existing structure, support, and established communication with patients. They also described nondocumentation-related use of the electronic health record system. Moreover, they reported dealing with a complicated patient group with varying needs and high expectations. The HCPs expressed that they worked in a patient-centered way and with patient engagement. The HCPs could see both the advantages and disadvantages of the PAEHR system and had some concerns. There were mixed views of the extent of the change, where some felt patient ORA would not affect their work at all and others expected a substantial impact. Some HCPs had experience using the PAEHR system themselves, while some lacked knowledge and interest. Furthermore, the implementation process was perceived as long and uneventful, with fragmented communication, where existing communication activities were used. The HCPs also reported receiving some information and education about PAEHRs outside the organization. The HCPs had limited awareness of how patients were introduced to the PAEHR system. CONCLUSIONS: This study underscores the importance of having a usable electronic health record system and addressing organizational issues, such as issues with the work environment, for optimal implementation of eHealth services such as the PAEHR system. It also highlights the importance of HCPs' views and experiences with their patients, and their perceptions and attitudes toward the intervention. Additionally, this study stresses the importance of effective implementation processes and communication strategies for both HCPs and patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,022 | 0,028 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,011 | 0,008 |
| Communication savante | 0,005 | 0,003 |
| Science ouverte | 0,001 | 0,005 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».