马萨诸塞州的电子处方协作：区域处方项目的早期经验
E-Prescribing collaboration in Massachusetts: early experiences from regional prescribing projects.
作者信息
Halamka John, Aranow Meg, Ascenzo Carl, Bates David W, Berry Kate, Debor Greg, Fefferman Jessica, Glaser John, Heinold Jerilyn, Stanley John, Stone Diane L, Sullivan Thomas E, Tripathi Micky, Wilkinson Bruce
机构信息
CareGroup Healthcare System and Harvard Medical School, 1135 Tremont Street, 6th Floor, Boston, MA 02215, USA.
出版信息
J Am Med Inform Assoc. 2006 May-Jun;13(3):239-44. doi: 10.1197/jamia.M2028. Epub 2006 Feb 24.
Massachusetts payers and providers have encouraged clinician usage of e-Prescribing technology to improve patient safety, enhance office practice efficiencies, and reduce medical costs. This report describes three early pilot e-Prescribing projects as case studies. These projects identified the e-Prescribing needs of clinicians, illustrated key issues that made implementation difficult, and clarified the impact of various types of functionality. The authors identified ten key barriers: (1) previous negative technology experiences, (2) initial and long-term cost, (3) lost productivity, (4) competing priorities, (5) change management issues, (6) interoperability limitations, (7) information technology (IT) requirements, (8) standards limitations, (9) waiting for an "all-in-one solution," and (10) confusion about competing product offerings including hospital/Integrated Delivery System (IDN)-sponsored projects. In Massachusetts, regional projects have helped to address these barriers, and e-Prescribing activities are accelerating rapidly within the state.
马萨诸塞州的医保支付方和医疗服务提供商鼓励临床医生使用电子处方技术，以提高患者安全、提升门诊效率并降低医疗成本。本报告将三个早期电子处方试点项目作为案例进行描述。这些项目确定了临床医生对电子处方的需求，阐明了实施过程中遇到的关键难题，并厘清了各类功能的影响。作者们确定了十个关键障碍：（1）以往负面的技术体验；（2）初始成本和长期成本；（3）生产力损失；（4）相互冲突的优先事项；（5）变革管理问题；（6）互操作性限制；（7）信息技术（IT）要求；（8）标准限制；（9）等待“一体化解决方案”；（10）对包括医院/综合医疗服务体系（IDN）发起的项目在内的竞争性产品供应感到困惑。在马萨诸塞州，区域项目有助于克服这些障碍，该州的电子处方活动正在迅速加速。
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