Background: The lack of interoperability has been a well-recognised limitation associated with the use of electronic health records (EHR). However, less is known about how it manifests for frontline NHS staff when delivering care, how it impacts patient care and what its implications are on care efficiency.

Objectives: (1) To capture the perceptions of NHS physicians regarding the current state of EHR interoperability, (2) to investigate how poor interoperability affects patient care and safety and (3) to explore the effects it has had on care efficiency in the NHS.

Methods: An online Qualtrics survey was conducted between June and October 2021 to explore how NHS physicians perceived the present state of interoperability among EHR in service, its effects on patient safety and its impact on care efficiency in NHS healthcare facilities. Recruitment was performed via convenience sampling and snowballing in collaboration with contacts at Health Education England deaneries and the Royal College of General Practitioners. Descriptive statistics were used to report any notable findings observed.

Results: A total of 636 NHS physicians participated, of which 218 (34.3%) completed the survey fully. Participants reported that EHR interoperability is rudimentary across much of the NHS, with limited ability to read but not edit data from within their organisation. Negative perceptions were most pronounced among specialties in secondary care settings and those with less than 1 year of EHR experience or lower self-reported EHR skills. Limited interoperability prolonged hospital stays, lengthened consultation times and frequently necessitated repeat investigations to be performed. Limited EHR interoperability impaired physician access to clinical data, hampered communication between providers and was perceived to threaten patient safety.

Conclusion: As healthcare data continues to increase in complexity and volume, EHR interoperability must evolve to accommodate these growing changes and ensure the continued delivery of safe care. The experiences of physicians provide valuable insight into the practical challenges limited interoperability poses and can contribute to future policy solutions to better integrate EHR in the clinical environment.

Keywords: Digital Technology; Electronic Health Records; Health & safety; Health Services; Health informatics.

© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.

背景： 电子健康记录（EHR）的互操作性不足一直是一个广为人知的限制。然而，较少有人了解这种互操作性不足在前线NHS工作人员提供护理时如何表现、对患者护理的影响以及其对护理效率的影响。

目的： (1) 捕获NHS医生关于当前EHR互操作状态的看法；(2) 调查不良互操作性对患者护理和安全的影响；(3) 探索它在NHS内对护理效率的效应。

方法： 一项在线Qualtrics调查于2021年6月至10月进行，以探索NHS医生如何看待目前EHR之间的互操作性状况、其对患者安全的影响以及在NHS医疗设施中的护理效率影响。通过与英格兰健康教育局学区和英国全科医师学院的联系人合作，采用便利抽样法和滚雪球方法进行招募。使用描述性统计来报告观察到的任何显著发现。

结果： 共有636名NHS医生参与了调查，其中218名（34.3%）完成了所有问卷。参与者表示，在整个NHS中EHR互操作性基本处于初级阶段，组织内仅限于阅读但不能编辑数据的能力非常有限。次级护理领域和拥有不到一年的EHR经验或自我报告EHR技能较低的专业人士对这种状况的看法最为负面。有限的互操作性延长了住院时间、增加了咨询时间，并常常导致需要重复进行检查。有限的EHR互操作性阻碍了医生访问临床数据，妨碍了提供者之间的沟通，并被认为威胁到患者的安全。

结论： 随着医疗数据在复杂性和数量上不断增加，EHR互操作性必须适应这些不断变化的趋势并确保持续安全的护理交付。医生的经验为有限互操作性的实际挑战提供了宝贵的见解，并有助于未来的政策解决方案，在临床环境中更好地整合EHR。

关键词： 数字技术；电子健康记录；卫生与安全；医疗服务；医疗信息学。

© 作者（或其雇主）2025。根据CC BY许可重新使用。由BMJ集团发布。