医疗信息技术工具,以加快胃肠道评估在患有缺铁性贫血的患者:一个集群随机对照试验
Aparna Priyanath Gupta1, Dharmesh Patel2, Ji Young Lee3
1Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine,Northwestern University, Chicago, Illinois, USA apriyan1@nm.org.
BMJ open quality
|April 16, 2024
概括
电子健康记录工具和快速转诊没有改善铁缺乏性贫血患者内镜评估的完成. 医生的时间限制是实施这些系统级安全措施的关键障碍.
科学领域:
- 胃肠病学 胃肠病学
- 医疗信息学 医疗信息学
- 主要护理医学 医疗保健
背景情况:
- 在缺铁性贫血 (IDA) 的诊断评估中缺乏系统级的安全措施.
- 患有IDA的高风险患者需要及时和适当的诊断工作.
研究的目的:
- 评估电子健康记录 (EHR) 工具和加快转诊工作流是否有助于IDA患者的双向内镜短期完成.
- 评估实用性,集群随机试验对诊断评估率的影响.
主要方法:
- 一个务实,集群随机试验,涉及16名初级保健医生 (PCP) 和316名IDA患者.
- 干预组获得了EHR患者登记册,护理点警报和加速诊断工作流.
- 120天后评估结果,主要结果是完成双向内镜检查.
主要成果:
- 在干预组和对照组 (4%和3.5%) 之间,在初级结局 (双向内镜完成) 中没有发现显著差异.
- 二次结果,包括任何内镜检查,胃肠病学咨询和转诊命令,也没有显著改善.
- 医生缺乏利用EHR注册工具的时间被确定为一个重要的障碍.
结论:
- 实施EHR工具和IDA患者的加速转诊途径并没有增加短期内镜评估率.
- 当前的系统级干预措施可能在不解决医生工作流和时间限制的情况下是不够的.
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