数字耳镜:为什么瑞士的电子健康记录需要公民测试
Barbara C Biedermann1, Peter Grolimund1, Bruno Wildhaber1
1Association Swiss Health Data Space, Zurich, Switzerland.
Swiss medical weekly
|December 31, 2025
概括
瑞士的电子病例记录 (EPR) 系统因高成本和不切实际而失败. 公民主导的测试显示,需要重新设计,用户友好的数字健康记录系统,以确保成功采用和数据安全.
科学领域:
- 医疗信息学 医疗信息学
- 数字卫生系统 数字卫生系统
- 公共政策 公共政策
背景情况:
- 瑞士的电子病例记录 (EPR) 系统尽管投入了大量资金,但采用率极低 (<2%).
- 了解公民观点对于解决EPR采用危机和改善数字卫生基础设施至关重要.
研究的目的:
- 开展瑞士数字卫生基础设施的第一个由公民领导的现实评估,重点关注电子病例记录 (EPR).
- 从用户的角度确定改善EPR系统的关键障碍和机会.
主要方法:
- 一个由公民领导的"远征"涉及120名志愿者 ("救生员") 系统测试了EPR系统.
- 参与者打开了EPR,请求了健康数据,并记录了他们与数字健康基础设施的经验.
主要成果:
- 公民重视安全,个人控制的健康记录的概念.
- 目前的EPR实施在经济上是不可行的,估计开放全国,上传数据和检索保险索赔的成本超过数十亿美元.
- 95%的参与者希望从全面检查中获得结构化数据,这表明对有益的数字健康记录的需求.
结论:
- 目前的EPR系统是不切实际的和经济上不可持续的,需要基于证据的重新设计.
- 拟议的电子健康档案法 (E-GD) 修订为创建以患者和医生为中心的EPR系统提供了关键机会.
- 成功实施的建议包括默认EPR在出生时打开,人工智能驱动的数据自动化,精简的接口和利用EPR进行计费.
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