互操作性是一个经济问题吗? 电子处方的早期经验教训
Karim Keshavjee1, Felipe Cepeda1
1Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Studies in health technology and informatics
|February 13, 2026
概括
医疗保健互操作性采用是由经济因素驱动的,而不仅仅是技术. 激励和授权对健康信息交换系统的采用产生重大影响,如电子处方.
科学领域:
- 医疗信息学 医疗信息学
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
背景情况:
- 尽管对医疗保健互操作性进行了大量投资,但临床医生的采用仍然不一致.
- 许多提供者仍然使用过时的方法,如传真来交换健康信息,即使有成熟的技术标准.
研究的目的:
- 调查医疗保健互操作性采用的障碍主要是技术性的还是经济性的.
- 分析影响采用健康信息交换的经济因素.
主要方法:
- 在加拿大,美国和丹麦对电子处方的采用进行比较的案例研究.
- 分析不同的政策方法:自愿采用,基于惩罚的采用和全国范围的授权.
- 经济理论的应用,包括交易成本,外部性,Coase定理和信息不对称.
主要成果:
- 加拿大自愿的电子处方模式的普及程度有限.
- 美国在实施与医疗保险D部分相关的处罚后实现了显著的采用.
- 丹麦的全国范围的授权导致了几乎普遍的电子处方采用.
结论:
- 医疗保健互操作性采用受到利益相关者之间的成本和收益分配的重大影响,而不仅仅是技术.
- 经济设计原则对于实现可持续的健康数据交换和互操作性至关重要.
- 这些发现表明,需要将这种经济框架扩展到健康数据交换的其他领域.
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