访问量对电子工具改善心力衰竭护理效果的影响
Amrita Mukhopadhyay1, Harmony R Reynolds1, William C King2
1Leon H. Charney Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
JACC. Heart failure
|December 3, 2023
概括
电子健康记录 (EHR) 警报显著改善了心力衰竭药物处方对大量心脏病专家的处方. 这些EHR工具在繁忙的临床环境中尤其有价值,以增强指南推的治疗.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 临床试验研究 临床试验研究
背景情况:
- 电子健康记录 (EHR) 工具可以优化心力衰竭的指导方针推疗法,减少排气分数 (HFrEF).
- 电子病历工具的有效性可能会受到医生工作量的影响.
研究的目的:
- 为了确定医生工作量是否会改变EHR工具在HFrEF管理中的有效性.
- 评估EHR警报与常规护理信息对矿物质皮质皮质醇抗剂 (MRA) 处方的影响.
主要方法:
- 对BETTER CARE-HF集群随机试验的一个子组分析.
- 包括有HFrEF的成年人有资格接受MRA,但没有开处方.
- 医生工作量以访问量 (高与非高) 定义;分析了工作量与EHR工具有效性之间的相互作用.
主要成果:
- 在2211名患者和174名心脏病专家中,42.2%的患者被大量心脏病专家看过.
- 对于MRA处方的EHR警报的有效性因访问量 (P=0.02) 而显著改变.
- 警报显示,与非高容量心脏病专家相比,高容量心脏病专家的处方增加了5倍以上.
结论:
- 嵌入EHR的警报大大增加了MRA在大量心脏病实践中的处方.
- 调查结果支持使用EHR警报,特别是在苛刻的实践环境中.
- BETTER CARE-HF试验强调了EHR在改善HFrEF准则遵守方面的作用.
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