Hripcsak G, Knirsch C A, Jain N L, Stazesky R C, Pablos-Mendez A, Fulmer T
Department of Medical Informatics, Columbia University, New York, New York, USA.
Comput Biomed Res. 1999 Feb;32(1):67-76. doi: 10.1006/cbmr.1998.1496.
The purpose of this study was to use a health information network and innovative technology to coordinate tuberculosis care. An innercity medical center, a local health department, and a home care nurse service in northern Manhattan were used. The organizations were linked with computer networks. An automated decision support system with a natural language processor was used to detect tuberculosis cases and report them to the health department, and to select patients for respiratory isolation. Educational materials were placed on the World Wide Web and a Web-based kiosk. Home care nurses were outfitted with wireless pen-based computers, and data were relayed to the medical center. Automated tuberculosis case reporting resulted in time savings but not improved accuracy. Automated rules resulted in significant improvements in respiratory isolation. Kiosk educational materials were well-used. Wireless computing led to better access to information for both nurses and physicians, but not to reduction of workload. The key success element was recognition of critical priorities. It is concluded that innovative technology can facilitate the coordination of clinical care, public health, and home care.
本研究的目的是利用健康信息网络和创新技术来协调结核病护理。研究采用了曼哈顿北部的一家市中心医疗中心、一个地方卫生部门和一家家庭护理护士服务机构。这些组织通过计算机网络相连。使用带有自然语言处理器的自动化决策支持系统来检测结核病病例并将其报告给卫生部门，以及选择进行呼吸道隔离的患者。教育材料放置在万维网和基于网络的信息亭上。家庭护理护士配备了无线笔式计算机，数据被中继到医疗中心。自动化结核病病例报告节省了时间，但准确性并未提高。自动化规则使呼吸道隔离有了显著改善。信息亭教育材料得到了充分利用。无线计算使护士和医生都能更好地获取信息，但并未减轻工作量。关键的成功要素是认识到关键优先事项。结论是，创新技术可以促进临床护理、公共卫生和家庭护理的协调。
