Sidorov Jaan
Department of General Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA.
Health Aff (Millwood). 2006 Jul-Aug;25(4):1079-85. doi: 10.1377/hlthaff.25.4.1079.
Electronic health record (EHR) advocates argue that EHRs lead to reduced errors and reduced costs. Many reports suggest otherwise. The EHR often leads to higher billings and declines in provider productivity with no change in provider-to-patient ratios. Error reduction is inconsistent and has yet to be linked to savings or malpractice premiums. As interest in patient-centeredness, shared decision making, teaming, group visits, open access, and accountability grows, the EHR is better viewed as an insufficient yet necessary ingredient. Absent other fundamental interventions that alter medical practice, it is unlikely that the U.S. health care bill will decline as a result of the EHR alone.
电子健康记录(EHR)的支持者认为,电子健康记录能减少错误并降低成本。然而许多报告却给出了相反的结论。电子健康记录常常导致更高的计费,且提供者的生产力下降,而提供者与患者的比例却没有变化。减少错误的效果并不稳定,而且尚未与节省费用或医疗事故保险费联系起来。随着对以患者为中心、共同决策、团队协作、集体问诊、开放就医和问责制的关注度不断提高,电子健康记录最好被视为一种虽不充分但却必要的要素。如果没有其他改变医疗实践的根本性干预措施,仅靠电子健康记录不太可能使美国的医疗保健费用下降。