Abstract：
BACKGROUND: Data in Electronic Health Records (EHRs) is often poorly structured and standardized, which hampers data reuse. Research described some examples of interventions to increase and improve structured and standardized data, such as guidelines and policies, training and user friendly EHR interfaces. However, little is known about the translation of this knowledge into practical solutions. Our study aimed to specify the most effective and feasible interventions that enable better structured and standardized EHR data registration and described practical examples of successfully implemented interventions.
METHODS: A concept mapping approach was used to determine feasible interventions that were considered to be effective or have been successfully implemented in Dutch hospitals. A focus group was held with Chief Medical Information Officers and Chief Nursing Information Officers. After interventions were determined, multidimensional scaling and cluster analysis were performed to categorize sorted interventions using Groupwisdom™, an online tool for concept mapping. Results are presented as Go-Zone plots and cluster maps. Following, semi-structured interviews were conducted to describe practical examples of successful interventions.
RESULTS: Interventions were classified into seven clusters ranked from highest to lowest perceived effectiveness: (1) education on usefulness and need; (2) strategic and (3) tactical organizational policies; (4) national policy; (5) monitoring and adjusting data (6) structure of and support from the EHR and (7) support in the registration process (EHR independent). Interviewees emphasized the following interventions proven successful in their practice: an enthusiastic ambassador per specialty who is responsible for educating peers by increasing awareness of the direct benefit of structured and standardized data registration; dashboards for continuous feedback on data quality; and EHR functionalities that support (automating) the registration process.
CONCLUSIONS: Our study provided a list of effective and feasible interventions including practical examples of interventions that have been successful. Organizations should continue to share their best practices to learn from and attempted interventions to prevent implementation of ineffective interventions.
METHODS: A concept mapping approach was used to determine feasible interventions that were considered to be effective or have been successfully implemented in Dutch hospitals. A focus group was held with Chief Medical Information Officers and Chief Nursing Information Officers. After interventions were determined, multidimensional scaling and cluster analysis were performed to categorize sorted interventions using Groupwisdom™, an online tool for concept mapping. Results are presented as Go-Zone plots and cluster maps. Following, semi-structured interviews were conducted to describe practical examples of successful interventions.
RESULTS: Interventions were classified into seven clusters ranked from highest to lowest perceived effectiveness: (1) education on usefulness and need; (2) strategic and (3) tactical organizational policies; (4) national policy; (5) monitoring and adjusting data (6) structure of and support from the EHR and (7) support in the registration process (EHR independent). Interviewees emphasized the following interventions proven successful in their practice: an enthusiastic ambassador per specialty who is responsible for educating peers by increasing awareness of the direct benefit of structured and standardized data registration; dashboards for continuous feedback on data quality; and EHR functionalities that support (automating) the registration process.
CONCLUSIONS: Our study provided a list of effective and feasible interventions including practical examples of interventions that have been successful. Organizations should continue to share their best practices to learn from and attempted interventions to prevent implementation of ineffective interventions.
摘要：
背景：电子健康记录（EHR）中的数据通常结构和标准化较差，这阻碍了数据重用。研究描述了一些增加和改进结构化和标准化数据的干预措施的例子，如指导方针和政策，培训和用户友好的EHR界面。然而,人们对将这些知识转化为实际解决方案知之甚少。我们的研究旨在指定最有效和可行的干预措施，以实现更好的结构化和标准化的EHR数据注册，并描述成功实施干预措施的实际例子。
方法：使用概念图方法来确定在荷兰医院中被认为有效或已成功实施的可行干预措施。与首席医疗信息官和首席护理信息官举行了一个焦点小组。在确定干预措施后，使用Groupwands™进行多维缩放和聚类分析来对分类的干预措施进行分类，用于概念映射的在线工具。结果显示为Go-Zone图和聚类图。Follows,进行了半结构化访谈,以描述成功干预的实际例子.
结果：干预措施分为从最高到最低感知有效性的七个类别：（1）有用性和需求教育；（2）战略和（3）战术组织政策；（4）国家政策；（5）监测和调整数据（6）EHR的结构和支持以及（7）注册过程中的支持（独立于EHR）。受访者强调了以下在实践中被证明是成功的干预措施：每个专业都有热情的大使，负责通过提高对结构化和标准化数据注册的直接利益的认识来教育同行；对数据质量进行持续反馈的仪表板；以及支持（自动化）注册过程的EHR功能。
结论：我们的研究提供了一系列有效和可行的干预措施，包括成功的干预措施的实例。各组织应继续分享其最佳做法，以学习和尝试干预措施，以防止实施无效的干预措施。
方法：使用概念图方法来确定在荷兰医院中被认为有效或已成功实施的可行干预措施。与首席医疗信息官和首席护理信息官举行了一个焦点小组。在确定干预措施后，使用Groupwands™进行多维缩放和聚类分析来对分类的干预措施进行分类，用于概念映射的在线工具。结果显示为Go-Zone图和聚类图。Follows,进行了半结构化访谈,以描述成功干预的实际例子.
结果：干预措施分为从最高到最低感知有效性的七个类别：（1）有用性和需求教育；（2）战略和（3）战术组织政策；（4）国家政策；（5）监测和调整数据（6）EHR的结构和支持以及（7）注册过程中的支持（独立于EHR）。受访者强调了以下在实践中被证明是成功的干预措施：每个专业都有热情的大使，负责通过提高对结构化和标准化数据注册的直接利益的认识来教育同行；对数据质量进行持续反馈的仪表板；以及支持（自动化）注册过程的EHR功能。
结论：我们的研究提供了一系列有效和可行的干预措施，包括成功的干预措施的实例。各组织应继续分享其最佳做法，以学习和尝试干预措施，以防止实施无效的干预措施。
