Branger P J, van der Wouden J C, Schudel B R, Verboog E, Duisterhout J S, van der Lei J, van Bemmel J H
Department of Medical Informatics, Erasmus University, Rotterdam, The Netherlands.
BMJ. 1992 Oct 31;305(6861):1068-70. doi: 10.1136/bmj.305.6861.1068.
To study the effects of the introduction of electronic data interchange between primary and secondary care providers on speed of communication, efficiency of data handling, and satisfaction of general practitioners with communication.
Comparison of traditional paper based communication for laboratory reports and admission-discharge reports between hospital and general practitioners and electronic data interchange.
Twenty-seven general practitioners whose offices were equipped with a practice information system and two general hospitals.
Paper based communication was evaluated by questionnaire responses from and interviews with care providers; electronic communication was evaluated by measuring time intervals between generation and delivery of messages and by assessing doctors' satisfaction with electronic data interchange by questionnaire.
Via paper mail admission-discharge reports took a median of 2-4 days, and laboratory reports 2 days, to reach general practitioners. With electronic data interchange almost all admission-discharge reports were available to general practitioners within one hour of generation. When samples were analysed on the day of collection (as was the case for 174/542 samples in one hospital and 443/854 in the other) the laboratory reports were also available to the general practitioner the same day via electronic data interchange. Fifteen general practitioners (of the 24 who returned the questionnaire) reported that the use of electronic admission-discharge reports provided more accurate and complete information about the care delivered to their patients. Ten general practitioners reported that electronic laboratory reports lessened the work of processing the data.
Electronic communication between primary and secondary care providers is a feasible option for improving communication.
研究在初级和二级医疗服务提供者之间引入电子数据交换对沟通速度、数据处理效率以及全科医生对沟通的满意度的影响。
比较医院与全科医生之间传统的基于纸质的实验室报告和出入院报告沟通方式与电子数据交换。
27名办公室配备了实践信息系统的全科医生以及两家综合医院。
通过护理人员的问卷调查回复和访谈评估基于纸质的沟通；通过测量消息生成与传递之间的时间间隔以及通过问卷调查评估医生对电子数据交换的满意度来评估电子沟通。
通过纸质邮件，出入院报告送达全科医生的中位时间为2 - 4天，实验室报告为2天。采用电子数据交换时，几乎所有出入院报告在生成后一小时内全科医生即可获取。当样本在采集当天进行分析时（其中一家医院的542个样本中有174个，另一家医院的854个样本中有443个是这种情况），通过电子数据交换，全科医生当天也能获取实验室报告。在回复问卷的24名全科医生中，有15名报告称使用电子出入院报告能提供关于其患者所接受护理的更准确和完整的信息。10名全科医生报告称电子实验室报告减轻了数据处理工作。
初级和二级医疗服务提供者之间的电子沟通是改善沟通的可行选择。
