Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study

BMC Medical Informatics and Decision Making

Research

Edmond Li¹  Ara Darzi¹  Hutan Ashrafian¹  Jonathan Clarke²  Ana Luisa Neves³  Olivia Lounsbury⁴ 

[1]Institute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK

[2]Institute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK

[3]Centre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, UK

[4]Institute of Global Health Innovation, National Institute for Health and Care Research (NIHR) Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK

[5]Department of Primary Care and Public Health, Imperial College London, London, UK

[6]Department of Community Medicine, Health Information and Decision, Center for Health Technology and Services Research, University of Porto, Porto, Portugal

[7]Johns Hopkins Children’s Center, Baltimore, MD, USA

关键词: Electronic health records;    Interoperability;    Patient safety;    Health IT;    Health policy;    Qualitative research;    Semi-structured interviews;   

DOI  :  10.1186/s12911-023-02255-8

 received in 2022-12-12, accepted in 2023-08-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn the era of electronic health records (EHR), the ability to share clinical data is a key facilitator of healthcare delivery. Since the introduction of EHRs, this aspect has been extensively studied from the perspective of healthcare providers. Less often explored are the day-to-day challenges surrounding the procurement, deployment, maintenance, and use of interoperable EHR systems, from the perspective of healthcare administrators, such as chief clinical information officers (CCIOs).ObjectiveOur study aims to capture the perceptions of CCIOs on the current state of EHR interoperability in the NHS, its impact on patient safety, the perceived facilitators and barriers to improving EHR interoperability, and what the future of EHR development in the NHS may entail.MethodsSemi-structured interviews were conducted between November 2020 – October 2021. Convenience sampling was employed to recruit NHS England CCIOs. Interviews were digitally recorded and transcribed verbatim. A thematic analysis was performed by two independent researchers to identify emerging themes.ResultsFifteen CCIOs participated in the study. Participants reported that limited EHR interoperability contributed to the inability to easily access and transfer data into a unified source, thus resulting in data fragmentation. The resulting lack of clarity on patients' health status negatively impacts patient safety through suboptimal care coordination, duplication of efforts, and more defensive practice. Facilitators to improving interoperability included the recognition of the need by clinicians, patient expectations, and the inherent centralised nature of the NHS. Barriers included systems usability difficulties, and institutional, data management, and financial-related challenges. Looking ahead, participants acknowledged that realising that vision across the NHS would require a renewed focus on mandating data standards, user-centred design, greater patient involvement, and encouraging inter-organisational collaboration.ConclusionTackling poor interoperability will require solutions both at the technical level and in the wider policy context. This will involve demanding interoperability functionalities from the outset in procurement contracts, fostering greater inter-organisation cooperation on implementation strategies, and encouraging systems vendors to prioritise interoperability in their products. Only by comprehensively addressing these challenges would the full potential promised by the use of fully interoperable EHRs be realised.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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