Pallin Daniel J, Sullivan Ashley F, Kaushal Rainu, Camargo Carlos A
Int J Emerg Med. 2010 Apr 1;3(3):181-5. doi: 10.1007/s12245-010-0170-3.
Information technology may improve patient safety, and is a focus of health care reform. A minority of emergency departments (EDs) in Massachusetts, and in academic EDs throughout the US, have electronic health records.
Assess health information technology adoption in a nationwide sample of EDs.
We surveyed 69 US EDs, asking site investigators about the availability of health information technology in 2005-2006. Using multiple linear regression, we compared adoption of technology by ED type (emergency medicine residency affiliation, annual census, US region) to assess generalizability of the findings.
Sixty-eight EDs (99%) provided information about health information technology; 75% were affiliated with an emergency medicine residency, and all were urban. Most respondents had applications that simply relay information from one place to another, including patient tracking (74%); ordering tests (laboratory 57%, others 62%); and displaying prior visit notes (79%), ECGs (92%), laboratory (97%), and radiology (99%) results. A minority had more-advanced applications, which seek to modify human behavior, including medication ordering (38%), allergy warnings (19%), and medication cross-reaction warnings (13%), and a few used bar coding (20%). There were no significant differences in technology adoption by ED type.
This and prior studies suggest that some applications-particularly those relevant to modifying clinician behavior-are not widespread in US EDs, while others are. The reasons for this are unknown, but might include expense and unintended consequences. The fact that the emergency medicine community has not rushed to adopt certain applications presents challenges and opportunities.
信息技术可能会提高患者安全，并且是医疗改革的一个重点。马萨诸塞州少数急诊科以及美国各地的学术性急诊科拥有电子健康记录。
评估全国范围内急诊科对健康信息技术的采用情况。
我们调查了69家美国急诊科，询问现场调查人员2005 - 2006年健康信息技术的可用性。使用多元线性回归，我们比较了不同类型急诊科（急诊医学住院医师培训所属机构、年就诊人数、美国地区）对技术的采用情况，以评估研究结果的普遍性。
68家急诊科（99%）提供了有关健康信息技术的信息；75%与急诊医学住院医师培训有关联，且均位于城市地区。大多数受访者拥有的应用程序只是简单地将信息从一个地方传输到另一个地方，包括患者跟踪（74%）；下达检查医嘱（实验室检查57%，其他检查62%）；以及显示既往就诊记录（79%）、心电图（92%）、实验室检查结果（97%）和放射学检查结果（99%）。少数急诊科拥有更先进的应用程序，旨在改变人类行为，包括药物医嘱下达（38%）、过敏警告（19%）和药物交叉反应警告（13%），还有少数使用条形码（20%）。不同类型急诊科在技术采用方面没有显著差异。
本研究及先前的研究表明，一些应用程序——尤其是那些与改变临床医生行为相关的应用程序——在美国急诊科中并不普遍，而其他一些应用程序则较为普遍。其原因尚不清楚，但可能包括费用和意外后果。急诊医学界尚未急于采用某些应用程序这一事实既带来了挑战，也带来了机遇。
