McVeigh Francis L, Tarbett Aaron K, Betts Aaron M, Boal Thomas R
Walter Reed Army Medical Center, Optometry Clinic, Washington, DC, USA.
Optometry. 2008 Jan;79(1):43-9. doi: 10.1016/j.optm.2007.06.013.
Health information technology (HIT) consists of technological advancements in health care instrumentation, integration, and documentation. It is now beginning to reach a level of consistency, and its benefits are being realized in clinical practice. Comparisons between paper and digital documentation have been conducted in various specialties. There have also been studies comparing manual and automated documentation. Our study was designed to compare the overall benefit of an electronic health record (EHR) and clinical automation accompanied with HIT advancements to traditional modes of practice within the Optometry Clinic at Walter Reed Army Medical Center.
All processes and procedures used in the study were equivalent to those used in patient visits common to most optometric practices. They included patient check-in, pretesting by an ophthalmic technician, and a comprehensive eye examination by an optometrist. In addition to the quantitative time measurements for these procedures, the frequency of certain events was recorded to ascertain the value of automation versus conventional methods of patient management, testing, treatment, and documentation.
Although no process time showed any statistically significant difference, some trends were evident. There was a trend toward increased efficiency in the automated group during "Doctor Examination" and "Total Time" subsections. Also, there was a trend toward decreased efficiency with the automated group during the "Check-In" section.
Automation and EHR technology will likely improve over time and surpass the medical efficiency of conventional modes of care. It is impressive that the early stage of HIT used in this study showed no detraction from clinical efficiency while potentially offering many patient, provider, and administrative benefits.
健康信息技术（HIT）包括医疗保健仪器、整合及文档记录方面的技术进步。如今它正开始达到一定程度的一致性，并且其益处也在临床实践中得以体现。不同专业领域已对纸质文档和数字文档进行了比较。也有研究对比了手动文档记录和自动文档记录。我们的研究旨在比较电子健康记录（EHR）以及伴随HIT进步的临床自动化相对于沃尔特·里德陆军医疗中心验光诊所传统诊疗模式的总体益处。
研究中使用的所有流程和程序等同于大多数验光诊疗中常见的患者就诊流程。这些流程包括患者登记、眼科技术员进行预测试以及验光师进行全面眼部检查。除了对这些程序进行定量时间测量外，还记录了某些事件的发生频率，以确定自动化与传统患者管理、测试、治疗及文档记录方法相比的价值。
尽管没有任何流程时间显示出统计学上的显著差异，但一些趋势很明显。在“医生检查”和“总时间”子部分中，自动化组有提高效率的趋势。此外，在“登记”部分，自动化组有降低效率的趋势。
随着时间推移，自动化和EHR技术可能会得到改进，并超过传统护理模式的医疗效率。令人印象深刻的是，本研究中使用的HIT早期阶段在不降低临床效率的同时，可能为患者、医疗服务提供者和管理部门带来诸多益处。
