背景:医疗保健服务中对牙科数据的需求以及纸质记录由于其固有的局限性而不足,导致了向电子牙科记录系统(EDR)的转变。实施EDR有许多障碍和挑战。因此,本研究旨在确定EDR的实施障碍和促进因素.
方法:这项描述性分析的横断面研究是针对在德黑兰的公共和私人诊所工作的牙医进行的,伊朗。设计了由三个部分组成的调查表,以收集有关牙医的人口统计信息的数据,五类障碍,包括金融障碍(6个问题),组织障碍(11个问题),技术壁垒(5个问题),个人障碍(3个问题),以及道德和法律障碍(6个问题),以及基于文献的EDR(15个问题)实施的促进者,用5分的李克特量表.来自60个牙科诊所的130名牙医参与了这项研究。数据采用描述性统计分析(计算频率分布,意思是,和标准偏差)。根据从非常低的重要性到非常高的重要性(包括非常低的重要性(平均值≤1.25))的四分位数,将平均分数分为四类。低重要性(1.25≥平均值<2.5),重要(2.5≥平均值<3.75),和非常高的重要性(平均≥3.75)。最后,使用Mann-WhitneyU检验比较了用户牙医和非用户牙医中的每个障碍和促进因素.数据采用SPSS软件进行分析。
结果:研究结果表明,牙医认为实施EDR的所有障碍和挑战都很重要,以及所有拟议的解决这些挑战的促进者都非常重要。这些重要的障碍包括高层管理人员和决策者的快速离职(5人中有3.69人)作为个人障碍,与电子记录相关的法律问题(5份中的3.65份)是道德法律障碍,缺乏不同系统之间数据交换的必要标准(5个中的3.64个)作为技术壁垒,牙医对该系统的益处的认识有限(5个中的3.63个),这是个人障碍,以及缺乏适用于EDR实施的法律基础设施(5个中的3.62个)作为道德法律障碍。此外,在非常重要的促进者中,对牙医和员工进行EDR培训(5个中的4.31个)值得注意。
结论:为了解决EDR实施的重要障碍,包括法律道德障碍,法律机构,监管机构必须建立相关的法律法规来克服这些障碍。此外,如果系统用户了解到这些功能,目标,好处,以及EDR对他们工作的积极影响,并获得必要的认识,他们对变化的抵抗力会降低,他们接受EDR的兴趣和意愿将会增加。
BACKGROUND: The need for dental data in healthcare services and the inadequacy of paper records due to their inherent limitations have led to a shift towards electronic dental record systems (EDR). Implementing EDR comes with numerous barriers and challenges. Therefore, this research was conducted to identify the implementation barriers and facilitators for EDRs.
METHODS: This descriptive-analytical cross-sectional study was conducted on dentists working in public and private clinics in Tehran, Iran. A questionnaire consisting of three sections was designed to collect data on the demographic information of dentists, the barriers in five categories including financial barriers (6 questions), organizational barriers (11 questions), technical barriers (5 questions), personal barriers (3 questions), and ethical and legal barriers (6 questions), as well as facilitators for the implementation of EDR (15 questions) based on the literature, using a five-point Likert scale. 130 dentists from 60 dental clinics participated in the study. The data were analyzed using descriptive statistics (calculating frequency distribution, mean, and standard deviation). The mean scores were classified into four categories based on quartiles from very low importance to very high importance including very low importance (mean ≤ 1.25), low importance (1.25 ≥ mean < 2.5), important (2.5 ≥ mean < 3.75), and very high importance (mean ≥ 3.75). Finally, each of the barriers and facilitators among user dentists and non-user dentists was compared using the Mann-Whitney U test. The data were analyzed using SPSS software.
RESULTS: The findings indicate that dentists consider all barriers and challenges in implementing EDR to be important, and all the proposed facilitators for addressing these challenges to be very important. Among these important barriers are the rapid turnover of managers and policymakers at higher levels (3.69 out of 5) as a personal
barrier, legal issues related to electronic records (3.65 out of 5) as an ethical-legal
barrier, the lack of necessary standards for data exchange between different systems (3.64 out of 5) as a technical
barrier, dentists\' limited awareness of the benefits of this system (3.63 out of 5) as a personal
barrier, and the lack of suitable legal infrastructure for EDR implementation (3.62 out of 5) as an ethical-legal
barrier. Additionally, among the very important facilitators, training dentists and staff on EDR (4.31 out of 5) is noteworthy.
CONCLUSIONS: To address the important barriers to EDR implementation, including legal-ethical barriers, legal institutions, and regulators must establish relevant laws and regulations to overcome these obstacles. Furthermore, if system users learn about the features, goals, benefits, and positive impact of EDR on their work and gain the necessary awareness, their resistance to changes will decrease, and their interest and readiness to accept EDR will increase.