Pallin Daniel, Lahman MeeMee, Baumlin Kevin
Departments of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA.
Acad Emerg Med. 2003 Aug;10(8):848-52. doi: 10.1197/aemj.10.8.848.
To describe acquisition and implementation of information technology (IT) in U.S. emergency medicine (EM) residency-affiliated emergency departments (EDs), including automatic medication error checking.
This was a survey of all U.S. EM residencies active in September 2000. Respondents specified whether specific IT tools had been "acquired" and "implemented fully." EDs were categorized according to primary versus affiliated training site, trauma level, and census. Numbers of "yes" responses were compared according to ED type (Kruskal-Wallis test, p < or = 0.05 significant).
Of 121 residency programs, data were obtained from 93 (77%) for a total of 149 EDs. The percentages of EDs that reported full implementation for each technology are as follows: medication error checking, 7%; medication order entry, 18%; nonmedication orders, 7%; clinical documentation, 21%; old electrocardiograms, 62%; laboratory results, 84%; radiography order entry, 62%; image retrieval, 29%; radiologists' interpretations, 67%; cardiology reports, 62%; pathology reports, 70%; surgical reports/dictations, 60%; triage, 34%; tracking, 46%; electronic reference materials, 56%; registration, 84%; accounts, 72%; patient management software package, 20%; voice recognition, 7%. Trauma centers reported more IT tools than nontrauma centers (p = 0.01), and primary training sites reported fewer IT tools than affiliated EDs (p = 0.027).
Incorporation of IT is not uniform in EDs where EM residents train. Acquisition of effective IT tools varies, and implementation lags behind acquisition. Fully implemented IT for medication error checking was reported in 7% of EDs; an additional 12% had acquired IT without implementing it fully.
描述美国急诊医学（EM）住院医师培训附属急诊科（ED）中信息技术（IT）的获取与实施情况，包括自动用药错误检查。
这是一项对2000年9月活跃的所有美国EM住院医师培训项目的调查。受访者指明特定的IT工具是否已被“获取”以及“全面实施”。急诊科根据主要培训地点与附属培训地点、创伤级别和人口普查进行分类。根据急诊类型比较“是”的回答数量（Kruskal-Wallis检验，p≤0.05具有显著性）。
在121个住院医师培训项目中，从93个项目（77%）获取了数据，涉及总共149个急诊科。报告每种技术全面实施的急诊科百分比如下：用药错误检查，7%；医嘱录入，18%；非用药医嘱，7%；临床文档，21%；旧心电图，62%；实验室结果，84%；放射检查医嘱录入，62%；图像检索，29%；放射科医生解读，67%；心脏病学报告，62%；病理学报告，70%；外科报告/口述记录，60%；分诊，34%；追踪，46%；电子参考资料，56%；挂号，84%；账目，72%；患者管理软件包，20%；语音识别，7%。创伤中心报告的IT工具比非创伤中心多（p = 0.01），主要培训地点报告的IT工具比附属急诊科少（p = 0.027）。
在EM住院医师培训的急诊科中，IT的整合并不统一。有效IT工具的获取各不相同，且实施落后于获取。7%的急诊科报告用药错误检查的IT已全面实施；另有12%已获取IT但未全面实施。
