Staes Catherine J, Evans R Scott, Rocha Beatriz H S C, Sorensen John B, Huff Stanley M, Arata Joan, Narus Scott P
Department of Biomedical Informatics, University of Utah School of Medicine, (RSE, SMH, SPN, CJS), Salt Lake City, UT,USA.
J Am Med Inform Assoc. 2008 May-Jun;15(3):324-32. doi: 10.1197/jamia.M2608. Epub 2008 Feb 28.
Authors evaluated the impact of computerized alerts on the quality of outpatient laboratory monitoring for transplant patients. For 356 outpatient liver transplant patients managed at LDS Hospital, Salt Lake City, this observational study compared traditional laboratory result reporting, using faxes and printouts, to computerized alerts implemented in 2004. Study alerts within the electronic health record notified clinicians of new results and overdue new orders for creatinine tests and immunosuppression drug levels. After implementing alerts, completeness of reporting increased from 66 to >99 %, as did positive predictive value that a report included new information (from 46 to >99 %). Timeliness of reporting and clinicians' responses improved after implementing alerts (p <0.001): median times for clinicians to receive and complete actions decreased to 9 hours from 33 hours using the prior traditional reporting system. Computerized alerts led to more efficient, complete, and timely management of laboratory information.
作者评估了计算机化警报对移植患者门诊实验室监测质量的影响。对于在盐湖城LDS医院接受管理的356例门诊肝移植患者，这项观察性研究将使用传真和打印件的传统实验室结果报告与2004年实施的计算机化警报进行了比较。电子健康记录中的研究警报会通知临床医生肌酐检测和免疫抑制药物水平的新结果及逾期新订单。实施警报后，报告的完整性从66%提高到了>99%，报告包含新信息的阳性预测值也从46%提高到了>99%。实施警报后，报告的及时性和临床医生的反应得到了改善（p<0.001）：临床医生接收并完成操作的中位时间从使用先前传统报告系统时的33小时降至了9小时。计算机化警报实现了实验室信息更高效、完整和及时的管理。
