在电子健康记录数据中识别虚拟护理模式.
Annie E Larson1, Kurt C Stange2, John Heintzman1,3
1Research Department OCHIN Inc. Portland Oregon USA.
Learning health systems
|June 17, 2024
概括
虚拟护理模式,如仅有音频和视频访问,对于安全网诊所至关重要. 不一致的电子健康记录 (EHR) 数据可能会掩盖使用情况,可能会加剧健康不平等.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健的可访问性 医疗保健的可访问性
- 数字健康 公平数字健康 公平
背景情况:
- COVID-19大流行加速了虚拟护理的采用,突出了了解不同模式 (视频,音频,eVisits,eConsults,远程患者监控) 的需要.
- 在电子健康记录 (EHR) 中识别虚拟护理模式的不一致方法阻碍了准确的使用分析.
- 本研究通过开发一种方法来识别虚拟护理模式并描述它们随时间的分布来解决这一差距.
研究的目的:
- 开发和验证一种使用EHR数据对虚拟护理模式进行分类的方法.
- 在三年时间内描述初级保健安全网诊所虚拟护理模式的分布.
主要方法:
- 在2020年4月至2023年3月期间,利用了来自316家初级保健安全网诊所的EHR数据.
- 通过专家咨询开发了两个算法,以根据不同的EHR数据元素对虚拟护理访问方式进行分类.
- 进行描述性分析来比较算法协议和不同虚拟护理模式的频率.
主要成果:
- 算法显示了高度的同意 (所有访问的96.5%,虚拟护理访问的89.3%).
- 经常发生差异,只有音频访问被标记为视频访问.
- 只有音频访问是视频访问的两倍,当算法同意模式时.
结论:
- 虚拟护理模式分类对EHR数据元素敏感,由算法优先考虑.
- 安全网诊所在很大程度上依赖音频和视频访问来提供虚拟护理.
- 潜在的消除仅为音频访问的报销可能会加剧低收入人群的健康不平等.
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