Williams Faustine, Boren Suzanne Austin
Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO 65211, USA.
Inform Prim Care. 2008;16(2):139-45. doi: 10.14236/jhi.v16i2.685.
Most countries in Europe and the USA are increasingly using an electronic medical record (EMR) to help improve healthcare quality. Unfortunately, most developing countries face many challenges ranging from epidemics and civil wars to disasters: they also lack a robust healthcare infrastructure in the form of information and communications technology (ICT) to ensure continuity of patient health which many research studies consider a lifesaving resource. The aim of this systematic review is to examine the benefits of an EMR and its contribution to the development of healthcare delivery in developing countries.
We searched MEDLINE, PubMed, CINAHL, COMPENDEX and Academic Search Premier as well as systematically searching the reference lists of included studies and relevant reviews. Inclusion criteria were that studies should relate to the importance and challenges of an EMR system, paper-based medical records, development and implementation of an EMR system in developing countries or EMR impact on care delivery in developing countries.
A total of 23 articles were identified that met the eligibility criteria. Articles identified were grouped into five non-exclusive areas: EMR benefits (n=4), challenges (n=6), transition from paper-based to EMR (n=5), EMR in developing countries (n=8) and pilot projects (n=5). Nine articles were excluded because three were not published in English and six were studies on EMR in developed countries.
The potential of EMR systems to transform medical care practice has been recognised over the past decades, including the enhancement of healthcare delivery and facilitation of decision-making processes. Some benefits of an EMR system include accurate medication lists, legible notes and prescriptions and immediately available charts. In spite of challenges facing the developing world such as lack of human expertise and financial resource, most studies have shown how feasible it could be with support from developed nations to design and implement an EMR system that fits into this environment.
欧洲和美国的大多数国家越来越多地使用电子病历（EMR）来帮助提高医疗质量。不幸的是，大多数发展中国家面临着从流行病、内战到灾难等诸多挑战：它们还缺乏以信息通信技术（ICT）形式存在的强大医疗基础设施，以确保患者健康的连续性，而许多研究认为这是一种救生资源。本系统评价的目的是研究电子病历的益处及其对发展中国家医疗服务发展的贡献。
我们检索了MEDLINE、PubMed、CINAHL、COMPENDEX和学术搜索高级版，以及系统地检索了纳入研究和相关综述的参考文献列表。纳入标准为研究应涉及电子病历系统的重要性和挑战、纸质病历、发展中国家电子病历系统的开发与实施或电子病历对发展中国家医疗服务的影响。
共识别出23篇符合纳入标准的文章。识别出的文章分为五个非排他性领域：电子病历的益处（n = 4）、挑战（n = 6）、从纸质病历向电子病历的转变（n = 5）、发展中国家的电子病历（n = 8）和试点项目（n = 5）。排除9篇文章，因为3篇未以英文发表，6篇是关于发达国家电子病历的研究。
在过去几十年中，电子病历系统改变医疗实践的潜力已得到认可，包括改善医疗服务和促进决策过程。电子病历系统的一些益处包括准确的用药清单、清晰可读的记录和处方以及即时可用的图表。尽管发展中世界面临着缺乏专业人才和财政资源等挑战，但大多数研究表明，在发达国家的支持下，设计和实施适合这种环境的电子病历系统是可行的。
