Physicians' use of electronic medical records: Barriers and solutions

被引:483
作者
Miller, RH [1 ]
Sim, I
机构
[1] Univ Calif San Francisco, Inst Hlth & Aging, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Program Biol & Med Informat, San Francisco, CA 94143 USA
关键词
D O I
10.1377/hlthaff.23.2.116
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The electronic medical record (EMR) is an enabling technology that allows physician practices to pursue more powerful quality improvement programs than is possible with paper-based records. However, achieving quality-improvement through EMR use is neither low-cost nor easy. Based on a qualitative study-of physician practices that had implemented an EMR, we found that quality improvement depends heavily on physicians' use of the EMR-and not paper-for most of their daily tasks. We identified key barriers to physicians' use of EMRs. We then suggest policy interventions to overcome these barriers, including providing work/practice support systems, improving electronic clinical data exchange, and providing financial rewards for quality improvement.
引用
收藏
页码:116 / 126
页数:11
相关论文
共 26 条
[11]   Large employers' new strategies in health care [J].
Galvin, R ;
Milstein, A .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (12) :939-942
[12]  
HOFFMANN M, 1999, DESIGN PROCESS EMBED
[13]   Effects of computer-based clinical decision support systems on physician performance and patient outcomes - A systematic review [J].
Hunt, DL ;
Haynes, RB ;
Hanna, SE ;
Smith, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 280 (15) :1339-1346
[14]  
*IOM, 2002, FOST RAP ADV HLTH CA
[15]  
LEGROW G, 2000, ASPS EXECUTIVE REPOR
[16]  
Lynam KB, 2002, GROUP PRACT J, V51, P18
[17]   Giving patients access to their medical records via the Internet: The PCASSO experience [J].
Masys, D ;
Baker, D ;
Butros, A ;
Cowles, KE .
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 2002, 9 (02) :181-191
[18]   The barriers to electronic medical record systems and how to overcome them [J].
McDonald, CJ .
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 1997, 4 (03) :213-221
[19]  
McKnight LK, 1999, J AM MED INFORM ASSN, P320
[20]  
MILLER RH, 2003, UNPUB COSTS BENEFITS