在学习医疗保健系统中改进心血管指标提取能力的仪表板:混合方法研究研究
Anna G M Zondag1, Karin R Jongsma2, Wouter W van Solinge1
1Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands, 31 887569376.
Journal of medical Internet research
|December 22, 2025
概括
在学习医疗保健系统 (LHS) 中的仪表板没有改善心血管风险管理 (CVRM) 指标在电子健康记录 (EHR) 中的结构化注册. 挑战包括不清楚的责任,电子记录系统问题和时间限制,阻碍了CVRM数据提取能力.
科学领域:
- 医疗信息学 医疗信息学
- 心血管医学 心血管医学
- 提高质量 提高质量
背景情况:
- 心血管风险管理 (CVRM) 指南旨在管理心血管风险较高的患者.
- 遵守CVRM指导方针是可变的,需要改善医疗保健实践.
- 学习医疗保健系统 (LHS) 和仪表板是增强遵守和数据注册的潜在工具.
研究的目的:
- 评估LHS中实施仪表板是否改善了在电子健康记录 (EHR) 中对CVRM指标的结构化注册.
- 在现实环境中评估关键CVRM指标 (BMI,血压,吸烟状态,心血管疾病史,脂质,HbA1c,血红蛋白,eGFR) 的提取能力.
主要方法:
- 在仪表板实施过程中,在乌得勒支大学医学中心 (2022年1月至2023年11月) 进行了一项混合方法研究.
- 从电子健康记录中提取CVRM指标的量化评估,比较带有和没有仪表板的时期.
- 与临床医生进行的半结构面试 (N=5) 的专题分析,以了解人们的看法和障碍.
主要成果:
- 仪表板的实施并没有改善CVRM指标的提取能力;注册仍然低且稳定.
- 血红蛋白和估计的球过率是最容易提取的;心血管疾病史和吸烟状态是最难提取的.
- 与协议化时期相比,指标的提取能力下降了高达45%,原因是不清楚的责任,EHR的限制和时间限制.
结论:
- 仪表板未能在电子健康记录中加强对CVRM指标的结构化注册.
- 组织,技术和运营方面的问题阻碍了仪表板在改善CVRM数据采集方面的有效性.
- 结果为改善CVRM指标提取性提供了指导,有利于临床实践和现实数据研究.
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