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个性化医疗与商业成功:信息学能引领我们抵达应许之地吗?

Personalized health care and business success: can informatics bring us to the promised land?

作者信息

Ozbolt J G

机构信息

Vanderbilt University, Nashville, Tennessee 37232-8340, USA.

出版信息

J Am Med Inform Assoc. 1999 Sep-Oct;6(5):368-73. doi: 10.1136/jamia.1999.0060368.

Abstract

Perrow's models of organizational technologies provide a framework for analyzing clinical work processes and identifying the management structures and informatics tools to support each model. From this perspective, health care is a mixed model in which knowledge workers require flexible management and a variety of informatics tools. A Venn diagram representing the content of clinical decisions shows that uncertainties in the components of clinical decisions largely determine which type of clinical work process is in play at a given moment. By reducing uncertainties in clinical decisions, informatics tools can support the appropriate implementation of knowledge and free clinicians to use their creativity where patients require new or unique interventions. Outside health care, information technologies have made possible breakthrough strategies for business success that would otherwise have been impossible. Can health informatics work similar magic and help health care agencies fulfill their social mission while establishing sound business practices? One way to do this would be through personalized health care. Extensive data collected from patients could be aggregated and analyzed to support better decisions for the care of individual patients as well as provide projections of the need for health services for strategic and tactical planning. By making excellent care for each patient possible, reducing the "inventory" of little-needed services, and targeting resources to population needs, informatics can offer a route to the "promised land" of adequate resources and high-quality care.

摘要

佩罗的组织技术模型提供了一个框架,用于分析临床工作流程,并确定支持每种模型的管理结构和信息工具。从这个角度来看,医疗保健是一种混合模式,其中知识工作者需要灵活的管理和各种信息工具。一个表示临床决策内容的维恩图表明,临床决策各组成部分的不确定性在很大程度上决定了在特定时刻起作用的临床工作流程类型。通过减少临床决策中的不确定性,信息工具可以支持知识的适当应用,并使临床医生能够在患者需要新的或独特干预措施时发挥创造力。在医疗保健领域之外,信息技术为商业成功带来了突破性战略,否则这些战略是不可能实现的。健康信息学能否创造类似的奇迹,帮助医疗机构在建立健全商业实践的同时履行其社会使命?一种方法是通过个性化医疗保健。从患者那里收集的大量数据可以进行汇总和分析,以支持针对个体患者护理做出更好的决策,并为战略和战术规划提供卫生服务需求预测。通过使为每位患者提供优质护理成为可能、减少对需求不大的服务的“库存”,并将资源对准人群需求,信息学可以提供一条通往资源充足和高质量护理“应许之地”的途径。

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