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Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist

BACKGROUND: The digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers needed to measure hospitals’ electronic health record (EHR) usage and adoptions. The ministry of health has been measurin...

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Autores principales: Köse, İlker, Cece, Sinem, Yener, Songül, Seyhan, Senanur, Özge Elmas, Beytiye, Rayner, John, Birinci, Şuayip, Mahir Ülgü, Mustafa, Zehir, Esra, Gündoğdu, Berrin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500820/
https://www.ncbi.nlm.nih.gov/pubmed/37710253
http://dx.doi.org/10.1186/s12913-023-09859-w
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author Köse, İlker
Cece, Sinem
Yener, Songül
Seyhan, Senanur
Özge Elmas, Beytiye
Rayner, John
Birinci, Şuayip
Mahir Ülgü, Mustafa
Zehir, Esra
Gündoğdu, Berrin
author_facet Köse, İlker
Cece, Sinem
Yener, Songül
Seyhan, Senanur
Özge Elmas, Beytiye
Rayner, John
Birinci, Şuayip
Mahir Ülgü, Mustafa
Zehir, Esra
Gündoğdu, Berrin
author_sort Köse, İlker
collection PubMed
description BACKGROUND: The digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers needed to measure hospitals’ electronic health record (EHR) usage and adoptions. The ministry of health has been measuring the dissemination of meaningful usage and adoption of EHR since 2013 using Electronic Medical Record Adoption Model (EMRAM). The first published study about this analysis covered the surveys applied between 2013 and 2017. The results showed that 63.1% of all hospitals in Türkiye had at least basic EHR functions, and 36% had comprehensive EHR functions. Measuring the countrywide EHR adoption level is becoming popular in the world. This study aims to measure adoption levels of EHR in public hospitals in Türkiye, indicate the change to the previous study, and make a benchmark with other countries measuring national EHR adoption levels. The research question of this study is to reveal whether there has been a change in the adoption level of EHR in the three years since 2018 in Türkiye. Also, make a benchmark with other countries such as the US, Japan, and China in country-wide EHR adoption in 2021. METHODS: In 2021, 717 public hospitals actively operating in Türkiye completed the EMRAM survey. The survey results, deals with five topics (General Stage Status, Information Technology Security, Electronic Health Record/Clinical Data Repository, Clinical Documentation, Closed-Loop Management), was reviewed by the authors. Survey data were compared according to hospital type (Specialty Hospitals, General Hospitals, Teaching and Research Hospitals) in terms of general stage status. The data obtained from the survey results were analyzed with QlikView Personal Edition. The availability and prevalence of medical information systems and EHR functions and their use were measured. RESULTS: We found that 33.7% of public hospitals in Türkiye have only basic EHR functions, and 66.3% have extensive EHR functions, which yields that all hospitals (100%) have at least basic EHR functions. That means remarkable progress from the previous study covering 2013 and 2017. This level also indicates that Türkiye has slightly better adoption from the US (96%) and much better than China (85.3%) and Korea (58.1%). CONCLUSIONS: Although there has been outstanding (50%) progress since 2017 in Turkish public hospitals, it seems there is still a long way to disseminate comprehensive EHR functions, such as closed-loop medication administration, clinical decision support systems, patient engagement, etc. Measuring the stage of EHR adoption at regular intervals and on analytical scales is an effective management tool for policymakers. The bottom-up adoption approach established for adopting and managing EHR functions in the US has also yielded successful results in Türkiye.
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spelling pubmed-105008202023-09-15 Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist Köse, İlker Cece, Sinem Yener, Songül Seyhan, Senanur Özge Elmas, Beytiye Rayner, John Birinci, Şuayip Mahir Ülgü, Mustafa Zehir, Esra Gündoğdu, Berrin BMC Health Serv Res Research BACKGROUND: The digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers needed to measure hospitals’ electronic health record (EHR) usage and adoptions. The ministry of health has been measuring the dissemination of meaningful usage and adoption of EHR since 2013 using Electronic Medical Record Adoption Model (EMRAM). The first published study about this analysis covered the surveys applied between 2013 and 2017. The results showed that 63.1% of all hospitals in Türkiye had at least basic EHR functions, and 36% had comprehensive EHR functions. Measuring the countrywide EHR adoption level is becoming popular in the world. This study aims to measure adoption levels of EHR in public hospitals in Türkiye, indicate the change to the previous study, and make a benchmark with other countries measuring national EHR adoption levels. The research question of this study is to reveal whether there has been a change in the adoption level of EHR in the three years since 2018 in Türkiye. Also, make a benchmark with other countries such as the US, Japan, and China in country-wide EHR adoption in 2021. METHODS: In 2021, 717 public hospitals actively operating in Türkiye completed the EMRAM survey. The survey results, deals with five topics (General Stage Status, Information Technology Security, Electronic Health Record/Clinical Data Repository, Clinical Documentation, Closed-Loop Management), was reviewed by the authors. Survey data were compared according to hospital type (Specialty Hospitals, General Hospitals, Teaching and Research Hospitals) in terms of general stage status. The data obtained from the survey results were analyzed with QlikView Personal Edition. The availability and prevalence of medical information systems and EHR functions and their use were measured. RESULTS: We found that 33.7% of public hospitals in Türkiye have only basic EHR functions, and 66.3% have extensive EHR functions, which yields that all hospitals (100%) have at least basic EHR functions. That means remarkable progress from the previous study covering 2013 and 2017. This level also indicates that Türkiye has slightly better adoption from the US (96%) and much better than China (85.3%) and Korea (58.1%). CONCLUSIONS: Although there has been outstanding (50%) progress since 2017 in Turkish public hospitals, it seems there is still a long way to disseminate comprehensive EHR functions, such as closed-loop medication administration, clinical decision support systems, patient engagement, etc. Measuring the stage of EHR adoption at regular intervals and on analytical scales is an effective management tool for policymakers. The bottom-up adoption approach established for adopting and managing EHR functions in the US has also yielded successful results in Türkiye. BioMed Central 2023-09-14 /pmc/articles/PMC10500820/ /pubmed/37710253 http://dx.doi.org/10.1186/s12913-023-09859-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Köse, İlker
Cece, Sinem
Yener, Songül
Seyhan, Senanur
Özge Elmas, Beytiye
Rayner, John
Birinci, Şuayip
Mahir Ülgü, Mustafa
Zehir, Esra
Gündoğdu, Berrin
Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist
title Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist
title_full Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist
title_fullStr Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist
title_full_unstemmed Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist
title_short Basic electronic health record (EHR) adoption in (**)Türkiye is nearly complete but challenges persist
title_sort basic electronic health record (ehr) adoption in (**)türkiye is nearly complete but challenges persist
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500820/
https://www.ncbi.nlm.nih.gov/pubmed/37710253
http://dx.doi.org/10.1186/s12913-023-09859-w
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