Which functionalities are available in the electronic health record systems used by French general practitioners? An assessment study of 15 systems

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• 作者：David Darmon ; R茅my Sauvant ; Pascal Staccini ; Laurent Letrilliart
• 关键词：Electronic health record ; Evaluation study as a topic ; General practice
• 刊名：International Journal of Medical Informatics
• 出版年：January, 2014
• 年：2014
• 卷：83
• 期：1
• 页码：37-46
• 全文大小：583 K

文摘

Objective

Whereas an unprecedented effort is currently under way worldwide for the implementation of electronic health record (EHR) systems, their capabilities are poorly understood, especially in primary care. The objective of this study was to assess the main functionalities of the EHR systems used in French general practices.

Methods

Among the 20 EHR systems marketed in France, we assessed the 15 systems used by more than 1500 general practitioners in the Provence-Alpes-C么te d鈥橝zur region in the southeast part of France. Each EHR system was assessed in a general practice office, using two clinical vignettes describing virtual patient consultations. The evaluation criteria were derived from the EuroRec requirements for EHR system quality. The assessment scale included 37 criteria grouped into three sets: background data, consultation data, and exchange functionalities. The scoring system used, totalling 64 points, was based on the validation of the criteria and was adjusted based on the possibility of standardising the data. A high score indicated a good EHR system quality.

Results

The median global score was 32 points out of a possible 64 (range: 20-39). The median score was 12 points out of 22 (range: 6-15) for the background data set, 16 points out of 32 (range: 9-22) for the consultation data set, and four points out of 10 (range: 0-6) for the exchange functionalities. No association was found between the number of users and the assessment score of the EHR systems (m>pm> = 0.79). One third of the EHR systems lacked a problem list and only one of them supported the episode of care.

Conclusion

Functionalities noticeably vary among the EHR systems currently used in French primary care. Whereas these systems are globally very focused on drug prescriptions, several core functionalities are frequently lacking. They are also poorly interoperable for healthcare professionals and patients. Further research is necessary to assess their actual use.