England S P
Pershing & Yoakley, P.C., Knoxville, TN.
Top Health Inf Manage. 1993 Nov;14(2):38-47.
The health care industry is an information-dependent business that will require a new generation of health information systems if successful health care reform is to occur. We critically need integrated clinical management information systems to support the physician and related clinicians at the direct care level, which in turn will have linkages with secondary users of health information such as health payors, regulators, and researchers. The economic dependence of health care industry on the CPR cannot be underestimated, says Jeffrey Ritter. He sees the U.S. health industry as about to enter a bold new age where our records are electronic, our computers are interconnected, and our money is nothing but pulses running across the telephone lines. Hence the United States is now in an age of electronic commerce. Clinical systems reform must begin with the community-based patient chart, which is located in the physician's office, the hospital, and other related health care provider offices. A community-based CPR and CPR system that integrates all providers within a managed care network is the most logical step since all health information begins with the creation of a patient record. Once a community-based CPR system is in place, the physician and his or her clinical associates will have a common patient record upon which all direct providers have access to input and record patient information. Once a community-level CPR system is in place with a community provider network, each physician will have available health information and data processing capability that will finally provide real savings in professional time and effort. Lost patient charts will no longer be a problem. Data input and storage of health information would occur electronically via transcripted text, voice, and document imaging. All electronic clinical information, voice, and graphics could be recalled at any time and transmitted to any terminal location within the health provider network. Hence, health system re-engineering must begin and be developed where health information is initially created--in the physician's office or clinic.
医疗保健行业是一个依赖信息的行业，如果要成功进行医疗保健改革，就需要新一代的健康信息系统。我们迫切需要集成的临床管理信息系统来支持直接护理层面的医生和相关临床医生，而这些系统反过来又将与健康信息的二级用户（如医疗支付方、监管机构和研究人员）建立联系。杰弗里·里特表示，医疗保健行业对电子病历的经济依赖不可低估。他认为美国医疗行业即将进入一个全新的时代，在这个时代，我们的记录是电子化的，计算机相互连接，而我们的资金不过是通过电话线传输的脉冲信号。因此，美国现在正处于电子商务时代。临床系统改革必须从位于医生办公室、医院和其他相关医疗保健服务提供商办公室的基于社区的患者病历开始。一个整合了管理式医疗网络内所有服务提供商的基于社区的电子病历和电子病历系统是最合理的步骤，因为所有健康信息都始于患者记录的创建。一旦建立了基于社区的电子病历系统，医生及其临床同事将拥有一份共同的患者记录，所有直接服务提供商都可以访问该记录以输入和记录患者信息。一旦在社区提供商网络中建立了社区层面的电子病历系统，每位医生都将拥有可用的健康信息和数据处理能力，这最终将在专业时间和精力方面实现真正的节省。丢失患者病历将不再是问题。健康信息的数据输入和存储将通过转录文本、语音和文档成像以电子方式进行。所有电子临床信息、语音和图形都可以随时调用，并传输到医疗服务提供商网络内的任何终端位置。因此，医疗系统的重新设计必须在健康信息最初创建的地方——医生办公室或诊所开始并发展。
