Doolan David F, Bates David W, James Brent C
Clinical Services, Greater Newcastle Sector, Hunter Health, Newcastle, New South Wales, Australia.
J Am Med Inform Assoc. 2003 Jan-Feb;10(1):94-107. doi: 10.1197/jamia.m1127.
To describe advanced clinical information systems in the context in which they have been implemented and are being used.
Case series of five U.S. hospitals, including inpatient, ambulatory and emergency units. Descriptive study with data collected from interviews, observations, and document analysis.
The use of computerized results, notes, orders, and event monitors and the type of decision support; data capture mechanisms and data form; impact on clinician satisfaction and clinical processes and outcomes; and the organizational factors associated with successful implementation.
All sites have implemented a wide range of clinical information systems with extensive decision support. The systems had been well accepted by clinicians and have improved clinical processes. Successful implementation required leadership and long-term commitment, a focus on improving clinical processes, and gaining clinician involvement and maintaining productivity.
Despite differences in approach there are many similarities between sites in the clinical information systems in use and the factors important to successful implementation. The experience of these sites may provide a valuable guide for others who are yet to start, or are just beginning, the implementation of clinical information systems.
描述已实施并正在使用的先进临床信息系统所处的环境。
对五家美国医院进行案例系列研究，包括住院部、门诊部和急诊科。通过访谈、观察和文件分析收集数据进行描述性研究。
计算机化结果、记录、医嘱和事件监测器的使用情况以及决策支持的类型；数据捕获机制和数据形式；对临床医生满意度、临床流程及结果的影响；以及与成功实施相关的组织因素。
所有机构都实施了一系列具有广泛决策支持功能的临床信息系统。这些系统已被临床医生广泛接受，并改善了临床流程。成功实施需要领导力和长期投入，注重改善临床流程，让临床医生参与其中并保持工作效率。
尽管实施方法存在差异，但各机构在使用的临床信息系统以及对成功实施至关重要的因素方面有许多相似之处。这些机构的经验可能为尚未开始或刚刚开始实施临床信息系统的其他机构提供宝贵的指导。
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