发表机构
American Board of Family Medicine（美国家庭医学委员会）
机构由 AI 辅助整理，请以论文原文为准。AI 中文总结
基于2022-2026年ABFM问卷数据，分析家庭医生EHR满意度与互操作性趋势，发现满意度差距扩大且跨供应商互操作性低，构成质量安全威胁。
AI 中文摘要
目的：评估家庭医生（FPs）对电子健康记录（EHR）的满意度及其跨机构互操作性体验的趋势。材料与方法：对美国家庭医学委员会持续认证问卷（2022-2026年）五轮数据进行系列横断面分析。采用调整后的逻辑回归比较11种EHR系统中“非常满意”的几率；使用Cochran-Armitage检验评估供应商趋势。分别分析相同供应商和不同供应商来源的外部信息使用的便利性。结果：在36,785名家庭医生中，相对于Epic，调整后的“非常满意”几率从Elation Health的0.91（95%置信区间，0.74-1.11）到Oracle Health/Cerner的0.17（95%置信区间，0.15-0.20）不等。仅Epic用户的满意度显著提高（Benjamini-Hochberg调整后P<.001），导致供应商满意度差距扩大。在可比时间段内，使用不同供应商信息的便利性未改善；少于13%的人认为非常容易。Epic的互操作性优势因交换类型而反转：非Epic用户对相同供应商互操作性评为“非常容易”的几率不到Epic用户的一半（调整后比值比，0.41；95%置信区间，0.38-0.44），但对不同供应商互操作性的几率是Epic用户的1.54倍（95%置信区间，1.35-1.75）。讨论与结论：ABFM数据已在为EHR政策效果提供信息，但也对EHR市场具有实用价值。EHR满意度差异正在扩大，报告的使用不同供应商信息的便利性较低且未改变。虽然EHR满意度对负担和倦怠有已知影响，但互操作性是一个质量和安全威胁，可能因人工智能而加剧。
英文摘要
Objective: To assess trends in family physicians' (FPs) electronic health record (EHR) satisfaction and their experience of interoperability across organizations. Materials and Methods: Serial cross-sectional analysis of five waves of the American Board of Family Medicine's Continuous Certification Questionnaire (2022-26). Adjusted logistic regression compared odds of being very satisfied across 11 EHRs; Cochran-Armitage tests assessed vendor trends. Ease of using outside information was analyzed separately for same- and different-vendor sources. Results: Across 36,785 FPs, adjusted odds of being very satisfied relative to Epic ranged from 0.91 (95% CI, 0.74-1.11) for Elation Health to 0.17 (95% CI, 0.15-0.20) for Oracle Health/Cerner. Only Epic's users became significantly more satisfied (Benjamini-Hochberg adjusted P < .001), widening the vendor satisfaction gap. Within comparable periods, ease of using different-vendor information did not improve; fewer than 13% rated it very easy. Epic's interoperability advantage reversed by exchange type: non-Epic users had less than half the odds of Epic users of rating same-vendor interoperability very easy (adjusted OR, 0.41; 95% CI, 0.38-0.44) but 1.54 times the odds for different-vendor interoperability (95% CI, 1.35-1.75). Discussion: Rising national exchange volume has not yielded easier use of outside information. Epic's advantage is confined to its own network, so market concentration may shift, rather than solve, the different-vendor problem. Conclusion: The ABFM data are already informing EHR policy but also have utility for the EHR marketplace. While EHR satisfaction has known implications for burden and burnout, poor interoperability is a quality and safety threat that may be compounded by artificial intelligence.
Comments38 Pages, 4 Tables, 6 Figures, 8 Supplement Tables, 6 Supplement Figures
