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首页> 外文期刊>BMC Family Practice >Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents
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Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents

机译：学习使用电子健康记录：我们可以保持以患者为中心吗？与家庭医学居民的事前干预研究

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Background The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the “patient-centered” use of the EHR have been published. However, the impact of training to improve EHR use during clinical encounters is not well known. The aim of this study was to assess the impact of training on residents’ EHR-related communication skills and explore whether they varied according to the content of the consultation. Methods We conducted a pre-post intervention study at the Primary Care Division of the Geneva University Hospitals, Switzerland. Residents were invited to attend a 3-month training course that included 2 large group sessions and 2–4 individualized coaching sessions based on videotaped encounters. Outcomes were: 1) residents’ perceptions regarding the use of EHR, measured through a self-administered questionnaire and 2) objective use of the EHR during the first 10?min of patient encounters. Changes in practice were measured pre and post intervention using the Roter interaction analysis system (RIAS) and EHR specific items. Results Seventeen out of 27 residents took part in the study. Participants used EHR in about 30% of consultations. After training, they were less likely to consider EHR to be a barrier to the physician-patient relationship, and felt more comfortable using the EHR. After training, participants increased the use of signposting when using the EHR (pre: 0.77, SD 1.69; post: 1.80, SD3.35; p 0.035) and decreased EHR use when psychosocial issues appeared (pre: 24.5% and post: 9.76%, p?Conclusions This study suggests that training can improve residents’ EHR-related communication skills, especially in situations where patients bring up sensitive psychosocial issues. Future research should focus on patients’ perceptions of the relevance and usefulness of such skills.
机译：背景技术电子健康记录（EHR）现在被广泛应用于临床。由于使用EHR会对医患关系产生负面影响，因此已发布了有关以EHR的“以患者为中心”使用的一些建议。但是，在临床过程中进行培训以提高EHR使用率的影响尚不清楚。这项研究的目的是评估培训对居民与EHR相关的沟通技巧的影响，并根据咨询内容探讨他们是否有所不同。方法我们在瑞士日内瓦大学医院的初级保健部门进行了干预前研究。邀请居民参加为期3个月的培训课程，其中包括2个大型小组会议和2–4个基于录像相遇的个性化教练会议。结果是：1）居民对EHR的使用的看法（通过自我管理的问卷调查来衡量）; 2）在患者遇到的头10分钟内客观使用EHR。使用Roter相互作用分析系统（RIAS）和EHR特定项目对干预前后的实践变化进行了测量。结果27名居民中有17名参加了这项研究。大约30％的咨询参加者使用了EHR。训练后，他们不太可能将EHR视为医患关系的障碍，并且使用EHR感到更自在。培训后，参与者在使用EHR时增加了路标的使用（之前：0.77，SD 1.69; post：1.80，SD3.35; p 0.035），并且在出现心理社会问题时减少了EHR的使用（pre：24.5％和post：9.76％结论本研究表明，培训可以提高居民的与EHR相关的沟通技巧，尤其是在患者提出敏感的社会心理问题的情况下，未来的研究应集中于患者对此类技能的相关性和实用性的认识。

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