Weiner Michael, Callahan Christopher M, Tierney William M, Overhage J Marc, Mamlin Burke, Dexter Paul R, McDonald Clement J
Indiana University Center for Aging Research, Regenstrief Institute, Indiana University, Indianapolis 46202-2872, USA.
Ann Intern Med. 2003 Sep 2;139(5 Pt 2):430-6. doi: 10.7326/0003-4819-139-5_part_2-200309021-00010.
The high burden of illness and frailty common among our growing population of older adults often results in fragmentation of care across providers and health care systems, increasing the complexity and costs of caring for these patients. Information technology offers one way to meet this challenge. Scientists at the Regenstrief Institute have more than a quarter-century of experience in using medical informatics to support clinicians in the day-to-day care of older adults. Their research has progressed through several evolutionary cycles, beginning with the acquisition of relevant data and moving to studies of the most efficient and effective mechanisms that bring information to bear at the time of clinical decision making. Information technology designed with the input of the end user has the greatest promise of changing provider behavior because it balances technological challenges with the cultural context of the practice environment. One topic of active research is information technology to support transitions of care among sites and providers. These transitions place older adults at increased risk for avoidable illness, death, and health care costs. Information systems that improve communication among providers during these transitions have the potential to improve safety and reduce costs.
在不断增加的老年人群体中，常见的高疾病负担和身体虚弱往往导致医疗服务提供者和医疗系统之间的护理碎片化，增加了照顾这些患者的复杂性和成本。信息技术提供了一种应对这一挑战的方法。瑞根斯特里夫研究所的科学家在利用医学信息学支持临床医生对老年人进行日常护理方面拥有超过25年的经验。他们的研究经历了几个演进周期，从获取相关数据开始，进而研究在临床决策时最有效且高效地运用信息的机制。在终端用户参与下设计的信息技术最有希望改变医疗服务提供者的行为，因为它在技术挑战与实践环境的文化背景之间取得了平衡。一个正在积极研究的课题是支持不同场所和医疗服务提供者之间护理过渡的信息技术。这些过渡使老年人面临可避免疾病、死亡和医疗费用增加的风险。在这些过渡过程中改善医疗服务提供者之间沟通的信息系统有可能提高安全性并降低成本。
