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Does national regulatory mandate of provider order entry portend greater benefit than risk for health care delivery? The 2001 ACMI debate. The American College of Medical Informatics.医疗机构医嘱录入的国家监管规定对医疗服务而言,带来的益处是否大于风险?2001年美国医学信息学会辩论会。美国医学信息学会。
J Am Med Inform Assoc. 2002 May-Jun;9(3):199-208. doi: 10.1197/jamia.m1081.
2
Human factors considerations relevant to CPOE implementations.与计算机化医师医嘱录入系统实施相关的人为因素考量
J Healthc Inf Manag. 2005 Summer;19(3):71-8.
3
4
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J Biomed Inform. 2016 Apr;60:365-75. doi: 10.1016/j.jbi.2016.03.003. Epub 2016 Mar 8.
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Consumer-mediated health information exchanges: the 2012 ACMI debate.消费者主导的健康信息交流:2012 年 ACMI 辩论。
J Biomed Inform. 2014 Apr;48:5-15. doi: 10.1016/j.jbi.2014.02.009. Epub 2014 Feb 20.
6
Computerized provider order entry systems.计算机化医嘱录入系统。
Health Devices. 2001 Sep-Oct;30(9-10):323-59.
7
Privacy and security of health information in the emerging health care system.新兴医疗体系中健康信息的隐私与安全。
Health Matrix Clevel. 1995 Winter;5(1):1-36.
8
Improving the human computer interface design for a physician order entry system.改进医生医嘱录入系统的人机界面设计。
AMIA Annu Symp Proc. 2003;2003:847.
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Otolaryngol Clin North Am. 2002 Dec;35(6):1237-43, vii. doi: 10.1016/s0030-6665(02)00088-9.
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J Am Med Inform Assoc. 2005 Jan-Feb;12(1):20-7. doi: 10.1197/jamia.M1553. Epub 2004 Oct 18.

引用本文的文献

1
Thinking Together: Modeling Clinical Decision-Support as a Sociotechnical System.共同思考:将临床决策支持建模为社会技术系统。
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2
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EGEMS (Wash DC). 2015 Jul 9;3(2):1150. doi: 10.13063/2327-9214.1150. eCollection 2015.
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Lessons from a successful implementation of a computerized provider order entry system.计算机化医嘱录入系统成功实施的经验教训。
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Interventions to regulate ordering of serum magnesium levels: report of an unintended consequence of decision support.规范血清镁水平检测医嘱的干预措施:决策支持产生意外后果的报告
J Am Med Inform Assoc. 2005 Sep-Oct;12(5):546-53. doi: 10.1197/jamia.M1811. Epub 2005 May 19.
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Effect of CPOE user interface design on user-initiated access to educational and patient information during clinical care.计算机化医嘱录入(CPOE)用户界面设计对临床护理期间用户主动获取教育和患者信息的影响。
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本文引用的文献

1
Investigating physician order entry in the field: lessons learned in a multi-center study.调查现场的医生医嘱录入:多中心研究中的经验教训。
Stud Health Technol Inform. 2001;84(Pt 2):1107-11.
2
Information needs in primary care: a survey of rural and nonrural primary care physicians.基层医疗中的信息需求:对农村和非农村基层医疗医生的一项调查
Stud Health Technol Inform. 2001;84(Pt 1):338-42.
3
Order entry gets out of hand.订单录入变得失控。
Health Data Manag. 2001 Jul;9(7):20-2, 24.
4
Reducing medication errors.减少用药错误。
Am J Med Qual. 2001 May-Jun;16(3):81-6. doi: 10.1177/106286060101600302.
5
Experience using a programmable rules engine to implement a complex medical protocol during order entry.在医嘱录入过程中使用可编程规则引擎来实施复杂医疗协议的经验。
Proc AMIA Symp. 2000:829-32.
6
Improving residents' compliance with standards of ambulatory care: results from the VA Cooperative Study on Computerized Reminders.提高住院医师对门诊护理标准的依从性:退伍军人事务部计算机化提醒合作研究的结果
JAMA. 2000 Sep 20;284(11):1411-6. doi: 10.1001/jama.284.11.1411.
7
Incidence and preventability of adverse drug events in nursing homes.疗养院中药物不良事件的发生率及可预防性。
Am J Med. 2000 Aug 1;109(2):87-94. doi: 10.1016/s0002-9343(00)00451-4.
8
Is there a doctor in the house?这屋里有医生吗?
Manag Care. 1999 Sep;8(9):42-4.
9
Patient risk factors for adverse drug events in hospitalized patients. ADE Prevention Study Group.住院患者药物不良事件的患者风险因素。药物不良事件预防研究组。
Arch Intern Med. 1999 Nov 22;159(21):2553-60. doi: 10.1001/archinte.159.21.2553.
10
The Regenstrief Medical Record System: a quarter century experience.雷根斯特里夫医疗记录系统:四分之一个世纪的经验。
Int J Med Inform. 1999 Jun;54(3):225-53. doi: 10.1016/s1386-5056(99)00009-x.

医疗机构医嘱录入的国家监管规定对医疗服务而言,带来的益处是否大于风险?2001年美国医学信息学会辩论会。美国医学信息学会。

Does national regulatory mandate of provider order entry portend greater benefit than risk for health care delivery? The 2001 ACMI debate. The American College of Medical Informatics.

作者信息

Overhage J Marc, Middleton Blackford, Miller Randolph A, Zielstorff Rita D, Hersh William R

机构信息

Indiana University School of Medicine, Indianapolis, USA.

出版信息

J Am Med Inform Assoc. 2002 May-Jun;9(3):199-208. doi: 10.1197/jamia.m1081.

DOI:10.1197/jamia.m1081
PMID:11971880
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC344579/
Abstract

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.

摘要

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。