从荷兰的一般实践中学到的电子健康记录的适当处方的绩效支付计划的经验教训
I G Arslan1, R A Verheij2, K Hek1
1Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.
Health policy (Amsterdam, Netherlands)
|September 6, 2024
概括
荷兰的绩效支付 (P4P) 计划鼓励使用电子健康记录 (EHR) 进行适当的处方,但面临挑战. 提高电子健康统一性和沟通是P4P未来成功的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 一般的做法一般的做法
背景情况:
- 在荷兰 (2018-2023) 实施了一项全国性绩效支付 (P4P) 计划,以促进一般实践中的适当处方.
- 适当的处方是通过遵守配方产品来定义的,并使用电子健康记录 (EHR) 数据进行测量.
- 评估采用了学习健康系统的视角.
研究的目的:
- 评估一项全国性的绩效支付 (P4P) 计划,以在荷兰的一般实践中进行适当的处方.
- 确定在P4P倡议中使用电子健康记录 (EHR) 数据的好处和挑战.
- 为未来的P4P计划提供建议.
主要方法:
- 与15个主要利益相关者进行了半结构化访谈,包括全科医生,健康保险公司,药剂师,电子健康记录供应商和表单委员会成员.
- 用一个专题分析方法来分析采访数据.
主要成果:
- 电子健康记录 (EHR) 提供了好处,但系统的不统一性阻碍了一致的测量.
- 一般医生更喜欢特定的指标,而不是一般的指标,以便更好地控制性能.
- 利益相关者强调需要协同进行GP绩效反思,并指出沟通挑战.
- 该计划对处方行为的影响被认为是有限的,尽管观察到一些意想不到的好处,如改进的电子健康记录.
结论:
- 该研究确定了未来P4P计划利用EHR数据来增强适当护理的关键好处和挑战.
- 为了可靠的质量测量,在电子健康记录系统中实现更大的统一性至关重要.
- 未来的P4P计划应该优先考虑高质量的反,对等学习,以及为医疗保健提供者提供统一的通信道.
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