为低收入和中低收入国家实施开源电子健康记录系统的上下文障碍:范围审查
Sarah Bostan1,2,3, Owen A Johnson3, Lena J Jaspersen1
1Leeds University Business School, University of Leeds, Leeds, United Kingdom.
Journal of medical Internet research
|August 1, 2024
概括
开源电子健康记录 (EHR) 为低收入国家提供了潜力,但实施面临着技术问题以外的重大社会环境和组织障碍. 应对这些挑战对于改善医疗服务和数据管理至关重要.
科学领域:
- 全球卫生信息学
- 卫生技术实施 卫生技术实施
- 医疗保健中的开源软件
背景情况:
- 低收入和中低收入国家面临着全球流行病和慢性疾病的不成比例的负担,再加上有限的医疗保健机会.
- 开源电子健康记录 (EHR) 提供了一个具有成本效益和适应性的解决方案,以改变医疗保健技术交付和改善健康数据管理.
- 尽管有潜力,这些地区的开源EHR系统尚未得到广泛普及,研究往往过度强调技术实施障碍.
研究的目的:
- 在低收入和中低收入国家开展对开源电子健康记录系统适应和实施的上下文障碍进行跨学科范围审查.
- 确定未来研究的关键领域,以促进在资源有限的环境中成功采用开源EHR.
主要方法:
- 在医学,计算机和社会科学领域的7个数据库中进行了系统的范围文献审查.
- 通过混合方法评估工具和批判性评估技能计划的检查清单来评估研究质量.
- 通过一种叙事方法,根据PRISMA-ScR指导方针,对发现进行了定性综合.
主要成果:
- 13项研究揭示了关键障碍,包括资金有限,可持续性问题,组织和管理挑战,基础设施缺陷以及数据隐私,保护和所有权问题.
- 社会环境,技术和组织视角强调,数据保护,保密性,所有权和道德考虑是关键的,但往往被技术方面所掩盖.
- 现有的研究主要集中在技术挑战上,忽视了影响开源电子健康记录采用的关键社会环境和组织因素.
结论:
- 在低收入和中低收入国家成功实施开源电子健康资料是复杂的,需要一个全面的理解超越技术问题.
- 解决社会环境和组织障碍对于开源EHR的扩散至关重要,需要调整研究重点.
- 需要进一步的研究来澄清地方组织的作用,并全面了解实施者的经验,特别是关于伦理和数据保护管理的经验.
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