Background

Implementation of an electronic health record (EHR) that is fully integrated for clinical information, patient scheduling, and billing can effectively be shared by the entire healthcare community, both for the municipality and hospitals in Central Norway. The role and involvement of healthcare workers (HCW) in the implementation process might affect the standardization process.

Purpose

This article focuses on the HCW' involvement in the Willow module's standardization and how they will support the adapted systems from Epic's implementation process of the electronic health record.

Methods

This is a descriptive 6-month follow-up study, based on observations of 35 directions and building sessions from August to January 2019 in the Willow module. Structured interviews of 20 informants in November were used to cross-check and validate the observations. The analytical approach was conducted in four general contexts: a) traditional, b) practical, c) emotional, and d) analytical, obtained from the contextual-content analysis. This is discussed based on the system theory.

Results

A) Traditional: Epic's normative perspective predominates with a tight agenda, questions that should be answered, focuses on standardization of workflow and concepts and had low degree of discussion and involvement, especially in direction sessions. b) Practical: HCW' involvement in standardization provides a high degree of practicality in the sessions, which is also a rational achievement. c) Emotional: The sessions' expressive and affective achievement is guided by the HCW' engagement in standardization, dependent on knowledge and background. d) Analytic: The HCW' intellectual involvement in the standardization of workflows and concepts will be, to some degree, an agreement of objective terms.

Conclusions

HCW’ involvement in standardization will have a supportive function. They will be involved in different contexts and be a part of the end product Willow module, even though Epic controls these.

中文翻译：

---

Epic 实施 Willow 模块以及参与标准化的医护人员

背景

完全集成临床信息、患者调度和计费的电子健康记录 (EHR) 的实施可以由整个医疗保健社区有效共享，包括挪威中部的市政当局和医院。医疗工作者 (HCW) 在实施过程中的作用和参与可能会影响标准化过程。

目的

本文重点介绍 HCW 参与 Willow 模块的标准化以及他们将如何支持来自 Epic 电子健康记录实施过程的改编系统。

方法

这是一项描述性的 6 个月后续研究，基于对 Willow 模块中从 8 月到 2019 年 1 月的 35 个方向和构建会话的观察。11 月份对 20 名知情人进行了结构化访谈，用于交叉检查和验证观察结果。分析方法在四种一般情况下进行：a）传统，b）实用，c）情感，d）分析，从上下文内容分析中获得。这是基于系统论的讨论。

结果

A) 传统：Epic 的规范观点占主导地位，议程紧，问题应该回答，侧重于工作流程和概念的标准化，讨论和参与程度低，尤其是在指导会议中。b) 实用性：HCW 参与标准化在课程中提供了高度的实用性，这也是一个合理的成就。c) 情感：会议的表达和情感成就受 HCW 参与标准化的指导，取决于知识和背景。d) 分析性：HCW 在工作流和概念标准化中的智力参与在某种程度上将是客观术语的一致。

结论

HCW 参与标准化将具有支持功能。它们将涉及不同的上下文并成为最终产品 Willow 模块的一部分，即使 Epic 控制这些。