一个电子触发器来检测与远程医疗相关的诊断错误
Daniel R Murphy1,2, Himabindu Kadiyala2,3, Li Wei1,2
1Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Journal of telemedicine and telecare
|April 1, 2024
概括
一个电子触发工具确定了远程医疗初级保健中潜在的错过诊断. 该工具显示,错过的诊断机会具有11%的积极预测值,突出了改善远程医疗安全的领域.
科学领域:
- 医疗信息学 医疗信息学
- 患者安全 患者安全
- 初级医疗保健医学 一级医疗保健医学
背景情况:
- 由于COVID-19的流行,在初级保健中加速了远程医疗的采用.
- 评估远程医疗初级保健的诊断安全性仍然是一个挑战.
研究的目的:
- 开发和验证电子触发器 (e-trigger) 工具,用于识别远程医疗初级保健中潜在的错过诊断机会.
- 评估在远程医疗访问期间进行的临床诊断的安全性.
主要方法:
- 使用Safer Dx触发工具框架创建一个e-trigger算法.
- 将电子触发器应用于来自128,761次远程医疗访问 (2020年4月至2021年3月) 的电子健康记录数据.
- 通过使用Revised Safer Dx仪器进行图表审查,验证了e-trigger阳性病例.
主要成果:
- 确定了318个可能涉及远程医疗访问的病例,需要进一步评估.
- 对100个随机选择的病例的图表审查揭示了11个错过诊断机会的情况.
- 电子触发器显示了11%的错失机会的积极预测值.
结论:
- 电子触发器可以帮助评估远程医疗支持的初级保健的安全性.
- 提高诊断安全性的测量对于确定远程医疗与面对面访问的适当使用至关重要.
相关概念视频
Errors occurring during blood pressure monitoring
720
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
720
Pulse rhythm
795
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
795
Methods of Documentation VII: EMR
832
Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare...
832
Electronic Distance Measuring Instruments
37
Electronic Distance Measuring Instruments (EDMs) are essential tools in modern surveying, offering precise distance measurements by emitting electromagnetic signals and calculating the time required for these signals to travel to a target and return. Two primary types of signals are used in EDMs — light waves and microwaves — each suited to specific environmental and distance requirements. Light-wave-based EDMs utilize either infrared or laser light, providing high accuracy over short...
37
Documentation of Nursing Diagnosis
1.2K
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
1.2K
Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K


