Overhage J Marc, Middleton Blackford, Miller Randolph A, Zielstorff Rita D, Hersh William R
Indiana University School of Medicine, Indianapolis, USA.
J Am Med Inform Assoc. 2002 May-Jun;9(3):199-208. doi: 10.1197/jamia.m1081.
The 2001 debate of the American College of Medical Informatics focused on the proposition that national regulatory mandate of computer-based provider order entry (CPOE), to take effect by the end of 2005, portends greater benefit than risk for health care delivery. Both sides accepted that provider order entry offers potential benefit. Those supporting the proposition emphasized public safety, noting that payers have little economic incentive to pay for quality and that a mandate would force vendors to improve the usability and value of their systems. They argued that the mandate would align the economic incentives to finally allow CPOE to be widely adopted. Those opposing the proposition emphasized the risks resulting from a mandate, including the direct implementation costs, the logistic issues of implementation, and the cost of failed implementations. They also noted the potential for errors introduced by the systems themselves and the fact that the safety and utility of commercially available CPOE products have yet to be proved.
2001年美国医学信息学会的辩论聚焦于这样一个观点:到2005年底生效的基于计算机的医嘱录入(CPOE)的国家监管指令,对医疗服务带来的益处大于风险。双方都承认医嘱录入有潜在益处。支持该观点的人强调公共安全,指出支付方几乎没有经济动机为质量付费,而指令将迫使供应商提高其系统的可用性和价值。他们认为该指令将调整经济激励措施,最终使CPOE得以广泛采用。反对该观点的人则强调指令带来的风险,包括直接的实施成本、实施中的后勤问题以及实施失败的成本。他们还指出系统本身可能引入错误,以及市面上可用的CPOE产品的安全性和实用性尚未得到证实。