Department of Internal Medicine, Gundersen Lutheran Health System, La Crosse, Wisconsin, USA.
J Am Med Inform Assoc. 2011 Mar-Apr;18(2):169-72. doi: 10.1136/jamia.2010.007229. Epub 2011 Feb 2.
There is controversy over the impact of electronic health record (EHR) systems on cost of care and safety. The authors studied the effects of an inpatient EHR system with computerized provider order entry on selected measures of cost of care and safety. Laboratory tests per week per hospitalization decreased from 13.9 to 11.4 (18%; p < 0.001). Radiology examinations per hospitalization decreased from 2.06 to 1.93 (6.3%; p < 0.009). Monthly transcription costs declined from $74,596 to $18,938 (74.6%; p < 0.001). Reams of copy paper ordered per month decreased from 1668 to 1224 (26.6%; p < 0.001). Medication errors per 1000 hospital days decreased from 17.9 to 15.4 (14.0%; p < 0.030), while near misses per 1000 hospital days increased from 9.0 to 12.5 (38.9%; p < 0.037), and the percentage of medication events that were medication errors decreased from 66.5% to 55.2% (p < 0.007). In this manuscript, we demonstrate that the implementation of an inpatient EHR with computerized provider order entry can result in rapid improvement in measures of cost of care and safety.
电子病历 (EHR) 系统对医疗成本和安全性的影响存在争议。作者研究了具有计算机医嘱录入功能的住院 EHR 系统对选定医疗成本和安全性指标的影响。每周每住院人次的实验室检测次数从 13.9 项降至 11.4 项（18%；p<0.001）。每次住院的放射学检查次数从 2.06 项降至 1.93 项（6.3%；p<0.009）。每月转录成本从 74596 美元降至 18938 美元（74.6%；p<0.001）。每月订购的复印纸令数从 1668 令降至 1224 令（26.6%；p<0.001）。每千个住院日的用药错误从 17.9 例降至 15.4 例（14.0%；p<0.030），而每千个住院日的接近错误从 9.0 例增至 12.5 例（38.9%；p<0.037），用药错误占用药事件的百分比从 66.5%降至 55.2%（p<0.007）。在本文中，我们证明了具有计算机医嘱录入功能的住院 EHR 的实施可以迅速改善医疗成本和安全性指标。
