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首页> 外文期刊>Frontiers in Public Health >Factors Influencing Development and Implementation of Patients' Access to Electronic Health Records—A Comparative Study of Sweden and the Netherlands
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Factors Influencing Development and Implementation of Patients' Access to Electronic Health Records—A Comparative Study of Sweden and the Netherlands

机译：影响发展和实施电子健康记录的发展的因素 - 瑞典与荷兰的比较研究

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Background: Patient-accessible electronic health records (PAEHRs) and associated national policies have increasingly been set up over the past two decades. Still little is known about the most effective strategy for developing and implementing PAEHRs. There are many stakeholders to take into account, and previous research focuses on the viewpoints of patients and healthcare professionals. Many known barriers and challenges could be solved by involving end-users in the development and implementation process. This study therefore compares barriers and facilitators for PAEHR development and implementation, both general and specific for patient involvement, that were present in Sweden and the Netherlands. Methods: There were a total of 14 semi-structured interviews with 16 key informants from both countries, on which content analysis was performed. The Consolidated Framework for Implementation Research was used to guide both the construction of the interview guides and the content analysis. Outcomes: The main barriers present in both countries are resistance from healthcare professionals and technical barriers regarding electronic health record systems and vendors. Facilitators varied across the two contexts, where the national infrastructure and program management were highlighted as facilitators in Sweden and stakeholder engagement (including patients and healthcare professionals) was described as a facilitator in both contexts. Strong leadership was also described as a critical success factor, especially when faced with healthcare professional resistance. Conclusion: Most of the major barriers and facilitators from both countries are covered in existing literature. This study, however, identified factors that can be seen as more practical and that would not have arisen from interviews with patients or physicians. Recommendations for policymakers include keeping the mentioned barriers in mind from the start of development and paving the way for facilitators, mainly strict policies, learning from peer implementers, and patient involvement, when possible. Implementers should focus on strong decision-making and project management and on preparing the healthcare organization for the PAEHR.
机译：背景：患者可访问的电子健康记录（Paehrs）和相关国家政策越来越多的二十几年越来越多地设立。仍然很少是众所周知的，即开发和实施Paehrs最有效的策略。有许多利益相关者考虑，之前的研究侧重于患者和医疗保健专业人员的观点。通过涉及开发和实施过程中的最终用户可以解决许多知名的障碍和挑战。因此，本研究比较了帕尔尔开发和实施的障碍和促进者，一般和特定于瑞典和荷兰的患者参与。方法：共有14个半结构化访谈，两个国家/地区的16个关键信息人员，进行了内容分析。综合实施研究框架用于指导访谈指南的构建和内容分析。结果：两国的主要障碍是医疗保健专业人员和有关电子健康记录系统和供应商的技术壁垒的抵抗力。促进者在两种情况下变化，国家基础设施和方案管理被强调为瑞典的促进者，利益相关者参与（包括患者和医疗保健专业人员）被描述为两种情况下的辅导员。强大的领导层也被描述为一个关键的成功因素，特别是当面对医疗保健的职业抵抗时。结论：现有文学中的大多数主要障碍和各国的主要障碍和辅导员都涵盖了现有文献。然而，这项研究确定了可以被视为更实用的因素，并且不会从与患者或医生的访谈中出现。关于政策制定者的建议包括从开发开始和铺平促进者的方式保持提到的障碍，主要是严格的政策，从同伴实施者学习，以及患者受累。实施者应专注于强大的决策和项目管理以及为帕尔尔准备医疗组织。

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