Egger Halbeis Christoph B, Epstein Richard H, Macario Alex, Pearl Ronald G, Grunwald Zvi
*Department of Anesthesiology, Stanford UniversitySchool of Medicine, Stanford, California, 300 Pasteur Drive, Stanford, CA 94305, USA.
Anesth Analg. 2008 Oct;107(4):1323-9. doi: 10.1213/ane.0b013e31818322d2.
Information technology has been promoted as a way to improve patient care and outcomes. Whereas information technology systems for ancillary hospital services (e.g., radiology, pharmacy) are deployed commonly, it has been estimated that anesthesia information management systems (AIMS) are only installed in a small fraction of United States (US) operating rooms. In this study, we assessed the adoption of AIMS at academic anesthesia departments and explored the motivations for and resistance to AIMS adoption.
Members of the Society of Academic Anesthesiology Chairs and the Association of Anesthesiology Program Directors were solicited by e-mail to participate in an online survey of AIMS adoption. Two months after closing the survey, another e-mail was sent with a single question asking for an update to their AIMS implementation status.
Surveys were fully completed by 48 (34%) of the 140 Society of Academic Anesthesiology Chairs and Association of Anesthesiology Program Directors departments surveyed, with 72 (51%) providing AIMS status information. Twenty of these 72 departments have an AIMS installed, 12 are currently implementing, 11 have selected but not yet installed, and 18 are planning to purchase an AIMS in 2008 or 2009. Therefore, at least 61 (44%) of all 140 US academic anesthesia departments have committed to AIMS. This estimated adoption rate is conservative because the numerator equals the affirmative responses, whereas the denominator equals the total population of academic departments. Among adopters, the top ranked anticipated benefits from installing an AIMS included improved clinical documentation, improved data collection for clinical research, enhancement of quality improvement programs, and compliance with requirements of regulatory authorities. The hospital provided funding in almost all facilities (90%), with co-funding by the anesthesia group in 35%.
At least 61 or 44% of the 140 US academic departments surveyed in this study have already implemented, are planning to acquire, or are currently searching for an AIMS. Adoption of AIMS technology appears to have reached sufficient momentum within academic anesthesiology departments to result in a fundamental change.
信息技术已被视作改善患者护理及治疗结果的一种方式。虽然医院辅助服务（如放射科、药房）的信息技术系统已普遍部署，但据估计，麻醉信息管理系统（AIMS）仅在美国一小部分手术室中安装。在本研究中，我们评估了学术麻醉科对AIMS的采用情况，并探讨了采用AIMS的动机及阻力。
通过电子邮件邀请学术麻醉学主席协会和麻醉学项目主任协会的成员参与一项关于AIMS采用情况的在线调查。在调查结束两个月后，又发送了一封电子邮件，其中包含一个单一问题，询问其AIMS实施状态的最新情况。
在接受调查的140个学术麻醉学主席协会和麻醉学项目主任协会部门中，有48个（34%）完全完成了调查，72个（51%）提供了AIMS状态信息。这72个部门中有20个已安装AIMS，12个正在实施，11个已选定但尚未安装，18个计划在2008年或2009年购买AIMS。因此，在所有140个美国学术麻醉科中，至少有61个（44%）已致力于采用AIMS。这一估计的采用率较为保守，因为分子等于肯定答复数，而分母等于学术部门的总数。在采用者中，安装AIMS预期的首要好处包括改善临床记录、改善临床研究的数据收集、加强质量改进计划以及符合监管机构的要求。几乎所有机构（90%）的医院都提供了资金，35%的机构由麻醉组共同出资。
在本研究中接受调查的140个美国学术部门中，至少有61个（44%）已经实施、计划购置或正在寻找AIMS。AIMS技术的采用在学术麻醉科似乎已获得足够的动力，从而导致根本性的变革。
