背景:电子健康记录(EHR)的推出代表了德国医疗保健系统数字化转型的核心组成部分。虽然EHR承诺更有效,更安全,从系统的角度对患者进行更快的治疗,EHR的成功实施在很大程度上取决于患者。在最近的一项调查中,四分之三的德国人表示他们打算使用EHR,而其他研究表明,使用技术的意图并不是实际使用的可靠和充分的预测指标。
目的:控制患者使用EHR的意图,我们调查了与疾病时程相关的疾病特异性风险认知和疾病相关的病耻感是否解释了患者将医学报告上传到EHR的决策中的额外差异.
方法:在一项在线用户研究中,241名德国参与者被要求与随机分配的医学报告互动,该报告在疾病相关的污名(高与低)和疾病时间过程(急性与慢性)方面有系统的变化,并决定是否将其上传到EHR。
结果:疾病相关的污名(比值比0.154,P<.001)抵消了使用意向和上传决定之间的一般正相关关系(比值比2.628,P<.001),而疾病的时间进程显示没有影响。
结论:即使患者通常打算使用EHR,与社会污名相关的疾病相关的风险认知可能会阻止人们将相关医疗报告上传到EHR。为了确保这一关键技术在数字化医疗保健系统中的可靠使用,全面保证有关EHR安全标准的透明和易于理解的信息,即使对于通常赞成使用EHR的人群也是如此。
BACKGROUND: The rollout of the electronic health record (EHR) represents a central component of the digital transformation of the German health care system. Although the EHR promises more effective, safer, and faster treatment of patients from a systems perspective, the successful implementation of the EHR largely depends on the patient. In a recent survey, 3 out of 4 Germans stated that they intend to use the EHR, whereas other studies show that the intention to use a technology is not a reliable and sufficient predictor of actual use.
OBJECTIVE: Controlling for patients\' intention to use the EHR, we investigated whether disease-specific risk perceptions related to the time course of the disease and disease-related stigma explain the additional variance in patients\' decisions to upload medical
reports to the EHR.
METHODS: In an online user study, 241 German participants were asked to interact with a randomly assigned medical report that varied systematically in terms of disease-related stigma (high vs low) and disease time course (acute vs chronic) and to decide whether to upload it to the EHR.
RESULTS: Disease-related stigma (odds ratio 0.154, P<.001) offset the generally positive relationship between intention to use and the upload decision (odds ratio 2.628, P<.001), whereas the disease time course showed no effect.
CONCLUSIONS: Even if patients generally intend to use the EHR, risk perceptions such as those related to diseases associated with social stigma may deter people from uploading related medical
reports to the EHR. To ensure the reliable use of this key technology in a digitalized health care system, transparent and easy-to-comprehend information about the safety standards of the EHR are warranted across the board, even for populations that are generally in favor of using the EHR.