用基于计算机的患者记录来管理艾滋病毒感染的指导方针
Lancet (London, England)
|August 5, 1995
概括
电子医疗记录通过减少警报和提醒响应时间,显著改善了临床医生遵守艾滋病毒临床实践指南. 这项技术增强了指导方针的遵守,但没有对初级保健访问或住院治疗产生负面影响.
科学领域:
- 临床信息学 临床信息学
- 医疗保健服务研究 医疗服务研究
- 传染病管理 传染病管理
背景情况:
- 计算机越来越多地集成到临床环境中.
- 遵守临床实践指南对于有效的患者护理至关重要.
- 电子医疗记录 (EMR) 提供了改善遵守指南的潜力.
研究的目的:
- 评估EMR中电子信息在加强遵守临床实践指南方面的有效性.
- 评估基于EMR的警报和提醒对临床医生的响应时间和艾滋病毒治疗患者结果的影响.
主要方法:
- 一个非随机的,受控的,前性试验,涉及126名医生和执业护士.
- 研究的重点是349名艾滋病毒感染患者在初级保健机构.
- 分析临床医生对警报和提醒,门诊访问和住院治疗的响应时间.
主要成果:
- 对警报的中位响应时间从52天 (对照组) 显著减少到11天 (干预组) (p < 0.0001).
- 对提醒的中位响应时间从500多天 (对照组) 显著减少到114天 (干预组) (p < 0.0001).
- 在初级保健访问,住院率或生存率上没有显著差异;然而,观察到眼科医生访问的增加.
结论:
- 带有电子消息的EMR系统是改善临床医生遵守实践指南的有效工具.
- 该干预表明,对临床提示的及时反应有显著的改善.
- 对特定的专家访问模式进行进一步调查可能是有必要的.
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