电子技术:一个火花来振兴初级保健?
Thomas Bodenheimer1, Kevin Grumbach
1Department of Family and Community Medicine, University of California, San Francisco, USA. tbodie@earthlink.net
JAMA
|July 10, 2003
概括
计算机革命为初级保健提供了巨大的潜力,但时间限制和成本等挑战阻碍了电子健康 (电子健康) 系统的广泛采用. 重新设计临床过程对于成功的整合至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 初级医疗保健医学 一级医疗保健医学
- 数字化健康转型
背景情况:
- 计算机革命提供了通过改善医疗记录,通信和信息获取来增强初级保健的机会.
- 在初级保健中广泛采用电子健康 (e-health) 面临重大障碍,包括时间,成本和互操作性问题.
- 确保患者隐私和解决对患者与医生关系的影响是电子健康实施的关键考虑因素.
研究的目的:
- 探索将计算机技术整合到初级保健机构的潜在好处和挑战.
- 确定阻碍在初级保健中广泛采用电子健康解决方案的关键障碍.
- 提出克服这些障碍并最大限度地利用计算机化的优势的策略.
主要方法:
- 文献综述和对现有关于初级保健计算机化的研究进行分析.
- 检查诸如时间承诺,成本,数据质量,互操作性,隐私,报销以及对患者与医生关系的影响等障碍.
- 评估特定计算机系统的有效性,如提醒提示和性能反.
主要成果:
- 计算机化系统,包括提醒提示和反机制,显示出改善医生的表现和患者结果的潜力.
- 电子健康采用的重大障碍包括过度的时间要求,高成本,信息质量不足,软件互操作性不足,隐私问题和保险退款有限.
- 医生采用电子健康工具取决于其效率和整合到工作流程中;过度耗时的系统往往未得到充分利用.
结论:
- 为了实现电子革命在初级保健中的好处,实践必须主动重新设计临床过程.
- 成功整合电子健康需要采取战略方法,确保技术支持,而不是阻碍医生工作流程.
- 克服已识别的障碍对于利用技术来改善初级保健提供和患者结果至关重要.
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