Minear Michael N, Sutherland Jeff
University of Maryland Medical System, Baltimore, Maryland, USA.
Semin Laparosc Surg. 2003 Jun;10(2):71-8. doi: 10.1177/107155170301000203.
For many years, computers have supported complex clinical ancillary functions such as the laboratory, radiology, endoscopy, and others. Digital computers have been successfully incorporated into specialized clinical instruments to offer advanced digital devices such as fetal monitors, heart monitors, and imaging equipment. But these devices are often not fully integrated with clinical management and operational systems. Beyond ancillary department applications, the result of almost 30 years of trying to automate the clinical processes in healthcare is large investments in both computer systems and paper medical records that have resulted in paper-based, computer-assisted processes of care. This expensive combination of partial clinical automation and archaic paper-based support processes is a major obstacle to improvements in care delivery and management. The need to use software, informatics, and standards to help manage the operating room and perioperative processes of care is significant. The potential to reduce adverse events, cost of care, and to enhance the quality of care are real and worth attaining. This paper focuses on what medical informatics improvements are needed to support improvements in surgical care and to assist in the management of the highly complex operating room and perioperative care process, and proposes research priorities in these areas.
多年来，计算机一直支持着诸如实验室、放射科、内窥镜检查等复杂的临床辅助功能。数字计算机已成功应用于专业临床仪器中，从而提供了如胎儿监护仪、心脏监护仪和成像设备等先进的数字设备。但这些设备往往并未与临床管理及操作系统完全集成。除了辅助科室应用外，近30年来在医疗保健领域尝试实现临床流程自动化的结果是，在计算机系统和纸质病历方面都投入了大量资金，这导致了基于纸质的、计算机辅助的护理流程。这种部分临床自动化与陈旧的纸质支持流程的昂贵组合，是改善护理提供和管理的主要障碍。利用软件、信息学和标准来帮助管理手术室及围手术期护理流程的需求十分迫切。降低不良事件、护理成本以及提高护理质量的潜力是切实存在且值得去实现的。本文重点探讨了需要哪些医学信息学方面的改进来支持手术护理的改善，并协助管理高度复杂的手术室及围手术期护理流程，并提出了这些领域的研究重点。
