COMPUTER BASED DOCUMENTATION AND PROVIDER INTERACTION

基于计算机的文档和提供商交互

• 批准号: 6054398
• 负责人: KEVIN B. JOHNSON
• 金额: $ 8.2万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2000-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6054398
• 关键词: age difference; clinical research; computer assisted patient care; computer human interaction; health services research tag; human subject; managed care; patient care management; pediatrics; population survey; primary care physician; social psychology

Programs for on-line documentation have become a popular addition to computer-based patient records. Most of these tools use personal computers and on-screen forms to construct a patient visit note. In a pediatric primary care or family practice setting, these programs potentially can improve compliance with age-appropriate screening, developmental testing, and immunization delivery guidelines. The computer also may remind the provider about issues to address and will help ensure complete documentation. However, computer-based documentation (CBD) may distract the provider, the patient, or the parent. Computers might cause parents to feel distanced from providers who focus attention on the computer to enter data. Computers might result in more time being spent completing documentation. Unfortunately, there are no controlled studies that have evaluated the effect of CBD on the quality of the health- maintenance encounter in a primary care practice setting. The aim of this project is to evaluate how using online documentation tools based on age-specific encounter guidelines for pediatric health-maintenance visits affects the quality of the encounter, as measured by the number of psychosocial and anticipatory guidance issues addressed during a visit, the parent and provider satisfaction with the encounter, and the duration of the encounter. These results will be evaluated with respect to different patterns of documenting the encounter (during the visit, after the visit, at the end of the clinic session.) The study utilizes a pre and post intervention design. The control group consists of encounters with families seen before the implementation of CBD. The intervention group consists of encounters that occurred two years later-1 year after the implementation of CBD. The study includes children under the age of 18 months, being seen for "well-child care." Each encounter is audiotaped. At the conclusion of the encounter, both the provider and the family are asked to complete an exit survey that assesses their satisfaction with the encounter. Providers also are asked to describe how they used CBD during this visit, and to assess how useful the electronic template was for this patient encounter. Data about the encounter's content and the provider's communication style will be obtained through an analysis of the audiotapes using a tool called the Roter Interactional Analysis System, which provides a reliable and valid analysis of patient, provider, computer interaction. Patient and provider satisfaction data will be derived from analysis of the exit survey.

在线文档的程序已成为基于计算机的患者记录的流行补充。 这些工具中的大多数都使用个人计算机和屏幕上的表格来构建患者访问说明。 在小儿初级保健或家庭实践环境中，这些计划可能会提高遵守适合年龄的筛查，发育测试和免疫交付指南。 计算机还可以提醒提供商有关要解决的问题，并将有助于确保完整的文档。 但是，基于计算机的文档（CBD）可能会分散提供者，患者或父母的注意力。计算机可能会导致父母与将注意力集中在计算机上进入数据的提供者距离。 计算机可能会导致更多时间完成文档。不幸的是，尚无对照研究评估了CBD对初级保健实践环境中健康维护质量的影响。该项目的目的是评估如何根据针对小儿健康维护访问的特定年龄遭遇指南使用在线文档工具会影响遭遇的质量，这是通过在访问期间解决的心理社会和预期指导问题的数量来衡量的，父母和提供者满意度与遭遇的满意度以及遭遇的持续时间。 这些结果将在记录相遇的不同模式（在访问期间，访问后，在诊所会议结束时）进行评估。该研究采用了干预前后的设计。 对照组包括与CBD实施之前看到的家庭相遇。 干预组由CBD实施后两年后1年发生的相遇组成。 该研究包括18个月以下的儿童，被视为“夫妇护理”。 每次相遇都是录音的。 在遭遇结束时，要求提供商和家庭完成一项出口调查，以评估他们对相遇的满意度。 还要求提供者描述他们在这次访问期间如何使用CBD，并评估电子模板对此患者遇到的有用。有关遭遇内容和提供商的通信方式的数据将通过使用称为Roter Interactional Analysis System的工具来分析录音带，该工具对患者，提供商，计算机交互提供了可靠且有效的分析。 患者和提供者满意度数据将从退出调查的分析中得出。

项目成果

Computer-based documentation: effect on parent and physician satisfaction during a pediatric health maintenance encounter.

基于计算机的文档：在儿科健康维护过程中对家长和医生满意度的影响。

• DOI: 10.1001/archpedi.159.3.250
• 发表时间: 2005
• 期刊: Archives of pediatrics & adolescent medicine
• 作者: Johnson,KevinB;Serwint,JanetR;Fagan,LawrenceM;Thompson,RichardE;Wilson,ModenaH
• 通讯作者: Wilson,ModenaH

Computer-based documentation: effects on parent-provider communication during pediatric health maintenance encounters.

基于计算机的记录：儿科健康维护过程中对家长与提供者沟通的影响。

• DOI: 10.1542/peds.2007-3005
• 发表时间: 2008
• 期刊: Pediatrics
• 影响因子: 8
• 作者: Johnson,KevinB;Serwint,JanetR;Fagan,LawrenceA;Thompson,RichardE;Wilson,ModenaEH;Roter,Debra
• 通讯作者: Roter,Debra