在电子医疗记录中使用旗:回顾性分析
Natalie Yass1, Rebekah Walker2, Sneha Nagavally2
1Medical College of Wisconsin, Milwaukee, Wisconsin, natalieyass000@gmail.com.
概括
医院电子医疗记录标志可能会显示偏差. 黑人男性患者和服用精神药物的患者更有可能获得"脆弱/不安全行为"标志,这表明需要标准化的标志协议.
科学领域:
- 医疗保健差异研究 医疗保健差异研究
- 医疗信息学医学信息学
- 患者安全 患者安全
背景情况:
- 医疗保健中的隐性偏见已被记录,但其在医院安全互动中的作用尚未得到充分研究.
- 电子医疗记录 (EMR) 标志识别高风险患者,包括那些与安全互动的患者.
- 了解旗模式对于解决潜在偏见至关重要.
研究的目的:
- 调查与安全相互作用相关的EMR标志的类型和频率.
- 为了确定不同类型的旗接收患者之间的人口和临床差异.
- 分析旗位置的时间趋势.
主要方法:
- 一个高等学术医疗中心13年来EMR旗的回顾性图表审查.
- 对成年患者 (18岁以上) 的分析.
- 描述性统计和千平方测试,以比较患者组和标志类型.
主要成果:
- 研究了三种类型的标志:"通信警报"",脆弱/不安全行为"和"风险管理".
- "通讯警报"标志是最常见的.
- 与"通讯警报"标志相比,黑人男性患者和服用抗焦虑,抗抑郁,抗精神病或心理治疗药物的患者更有可能获得"脆弱/不安全行为"标志 (P < 0.001).
- 在第三季度 (7月至9月) 发生的旗发病率最高.
结论:
- "易受伤害/不安全行为"的EMR标志不成比例地识别出具有特定人口统计和药物配置文件的患者.
- 缺乏明确的旗分配协议,引发了人们对透明度和潜在偏见的担忧.
- 建议采用标准化程序,以确保公平和透明的旗应用.
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