电子案例报告在美国的发展,实施和扩展.
Kimberly Knicely1, John W Loonsk2,3, Janet J Hamilton4
1Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, USA.
全国范围的电子病例报告 (eCR) 系统被开发和扩展以改善公共卫生监测. 这一举措显著增加了eCR能力,使公共卫生数据更及时,更完整.
科学领域:
- 公共卫生信息学 公共卫生信息学
- 卫生信息技术 信息技术
- 流行病学监测 流行病学监测
背景情况:
- 随着COVID-19大流行,人工公共卫生报告的局限性被暴露出来.
- 确定需要一个可扩展,可互操作的健康信息技术解决方案.
- 现有的系统造成了严重的临床和行政负担.
研究的目的:
- 描述电子案件报告 (eCR) 的发展和全国范围内的扩展.
- 评估eCR对公共卫生监测和流行病准备的影响.
- 评估eCR基础设施的可扩展性和互操作性.
主要方法:
- 开发和实施基于标准的eCR基础设施 (2014-2020年).
- 从2020年1月到2023年1月在全国范围内扩大eCR的规模.
- 评估能够使用eCR的电子健康记录 (EHR) 产品,可报告的情况以及医疗保健组织 (HCO) 和公共卫生机构 (PHA) 的连接.
- 关于停止手动报告和eCR及时性的数据质量研究.
主要成果:
- 能够使用eCR的EHR产品的数量增加了11倍 (3至33).
- 报告条件增加了28倍 (6至173).
- 连接的HCO增加了143倍 (153到22000);连接的PHA增加了2.75倍 (24到66).
- eCR的及时性不到1分钟,一些司法管辖区过渡到eCR独家报告.
结论:
- 电子监测系统的扩展显著提高了公共卫生监测能力.
- 与手动报告相比,eCR提供了更及时,更完整的数据.
- 可扩展的eCR基础设施减少了报告负担,并改善了疫情准备.
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