Mailman School of Public Health of Columbia University, Department of Sociomedical Sciences, New York, NY 10032, USA.
Med Care Res Rev. 2010 Oct;67(5 Suppl):268S-298S. doi: 10.1177/1077558710373769. Epub 2010 Jul 30.
Health information technology (health IT) has potential for facilitating quality improvement and reducing quality disparities found in underresourced settings (URSs). With this systematic literature review, complemented by key informant interviews, the authors sought to identify evidence regarding health IT and quality outcomes in URSs. The review included 105 peer-reviewed studies (2004-2009) in all settings. Only 15 studies included URSs, and 8 focused on URSs. Based on literature across settings, most evidence was available for quality impact of order entry, clinical decision support systems, and computerized reminders. Study designs were predominantly quasi-experimental (37%) or descriptive (35%); 90% of the studies focused on the microsystem level of quality improvement, indicating a need for expanding research into patient experience and organizational and environmental levels. Key informants highlighted organizational partnerships and health IT champions and emphasized that for health IT to have an impact on quality, there must be an organizational culture of quality improvement.
健康信息技术(health IT)在促进资源匮乏环境(URSs)中的质量改进和减少质量差距方面具有潜力。通过这项系统文献回顾,并辅以关键知情人访谈,作者旨在确定有关 URSs 中健康 IT 和质量结果的证据。该综述包括所有环境中的 105 项同行评审研究(2004-2009 年)。只有 15 项研究包括 URSs,其中 8 项专注于 URSs。基于跨环境的文献,大多数证据都可用于订单录入、临床决策支持系统和计算机提醒对质量的影响。研究设计主要是准实验(37%)或描述性(35%);90%的研究侧重于质量改进的微观系统层面,表明需要将研究扩展到患者体验以及组织和环境层面。关键知情人强调了组织伙伴关系和健康 IT 拥护者,并强调要使健康 IT 对质量产生影响,就必须有一个质量改进的组织文化。