使用电子健康记录在住院期间识别每日主要提供者
Nicholas E Ingraham1, Daniel Shyu1, Tom Phelan2
1Department of Medicine, University of Minnesota, Minneapolis, MN.
Critical care explorations
|December 19, 2024
概括
使用电子健康记录 (EHR) 数据的自动化算法准确地识别了住院患者的负责任医疗保健提供者. 这种方法通过考虑患者结果的提供者特定变化来改善医疗保健研究.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 提供者对临床结果的影响是显著的,但在医疗保健研究中往往没有被衡量.
- 目前用于识别负责任提供商的方法 (手动图表审查,索赔数据分析) 是低效或不准确的.
- 准确的提供者归因对于理解结果变化至关重要.
研究的目的:
- 开发和验证使用电子健康记录 (EHR) 数据的算法.
- 准确识别住院期间每个病人的每一天的负责提供者.
- 克服现有的提供商识别方法的局限性.
主要方法:
- 多中心回顾性队列研究.
- 使用EHR数据开发一个自动化算法.
- 与手动图表审查相对验证作为黄金标准.
主要成果:
- 手动图表审查显示了100%的评审者之间的可靠性.
- 与手动审查相比,自动化算法在识别负责任提供商方面取得了93%的准确性.
- 从200名随机选择的患者中,在3626个患者日中观察到高一致性.
结论:
- 电子健康记录 (EHR) 数据可以每天可靠,准确地将患者分配给提供者.
- 这种方法为医疗保健研究提供了一个可扩展的解决方案.
- 能够识别与干预无关的结果变化的来源.
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