Women's Health Care Delivery and Coordination After Transitioning From One Electronic Health Record to Another: Perspectives From Staff in the Veterans Health Administration.

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2024-10-12 DOI:10.1016/j.whi.2024.09.002
Samantha K Benson, Zoe H Pleasure, Ann Guillory, Sharon K Gill, Kristen E Gray
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Abstract

Objectives: The Veterans Health Administration (VA) is transitioning its 1,300 health care facilities from one electronic health record (EHR) to another. The transition aims to improve care delivery and interoperability; however, specific effects on women veterans, who comprise only 7.5% of the patient population, may be obscured without focused evaluation. We aimed to characterize the perspectives of VA staff regarding the impact of transitioning EHRs on women's health care delivery.

Methods: We conducted semistructured interviews with VA staff members involved in delivering or coordinating care for women at three sites that had transitioned EHRs within the past year. Interviews were audio-recorded and transcribed. We used a rapid, templated qualitative analytic approach to identify salient themes in the data.

Results: We interviewed 16 staff members across VA departments and roles. Although some participants felt the new EHR held promise, most identified challenges with the EHR rollout and implementation (e.g., insufficient training) and the EHR product (e.g., system inefficiencies and latency). Participants highlighted several ways the EHR transition disproportionately affected care delivery for women veterans, including via backlogs of community care referrals, insufficient opportunities for providers to gain proficiency with sex-specific workflows in the new EHR, and outdated listings for veterans who have changed their names. Participants reported that these issues affected their morale and contributed to decreases in productivity and delayed care.

Conclusions: Many of our findings reflect challenges that affect VA staff broadly, whereas others may be compounded among women veterans and the VA staff who serve them. To achieve the goal of delivering timely, equitable, high-quality, comprehensive health care services to women veterans, continued efforts to monitor and address the impacts of the EHR transition on this population are needed.

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从一种电子健康记录过渡到另一种电子健康记录后的妇女医疗服务提供与协调:退伍军人健康管理局工作人员的观点。
目标:退伍军人健康管理局 (VA) 正在将其 1,300 家医疗机构从一种电子健康记录 (EHR) 过渡到另一种。过渡的目的是改善医疗服务和互操作性;然而,如果不进行重点评估,可能会掩盖对仅占患者总数 7.5% 的女性退伍军人的具体影响。我们的目的是了解退伍军人事务部工作人员对电子病历过渡对女性医疗服务的影响的看法:我们对退伍军人事务部的工作人员进行了半结构化访谈,这些工作人员在过去一年中在三个已过渡使用电子病历的地点参与了为女性提供或协调医疗服务的工作。我们对访谈进行了录音和转录。我们采用快速、模板化的定性分析方法来确定数据中的突出主题:我们对退伍军人事务部各部门和各岗位的 16 名工作人员进行了访谈。尽管一些参与者认为新的电子病历很有前景,但大多数人认为电子病历的推广和实施(如培训不足)以及电子病历产品(如系统效率低下和延迟)存在挑战。与会者强调了电子病历过渡对女性退伍军人护理服务造成严重影响的几种方式,包括社区护理转诊积压、医疗服务提供者没有足够的机会熟练掌握新电子病历中针对不同性别的工作流程,以及针对已改名退伍军人的过时列表。参与者报告说,这些问题影响了他们的士气,导致工作效率下降和护理延误:我们的许多研究结果反映了退伍军人事务部工作人员普遍面临的挑战,而其他挑战则可能在女性退伍军人和为她们提供服务的退伍军人事务部工作人员中更为严重。为了实现向女性退伍军人提供及时、公平、优质、全面的医疗保健服务的目标,需要继续努力监测和解决电子病历过渡对这一人群的影响。
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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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