UTHealth-Memorial Hermann Center for Healthcare Quality & Safety, School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA.
BMC Med Inform Decis Mak. 2011 Feb 17;11:13. doi: 10.1186/1472-6947-11-13.
We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the clinical knowledge management features, functions, tools, and techniques required to deliver and maintain the clinical decision support (CDS) interventions required to support the recently defined "meaningful use" criteria.
We developed and fielded a 17-question survey to representatives from nine commercially available EHR vendors and four leading internally developed EHRs. The first part of the survey asked basic questions about the vendor's EHR. The second part asked specifically about the CDS-related system tools and capabilities that each vendor provides. The final section asked about clinical content.
All of the vendors and institutions have multiple modules capable of providing clinical decision support interventions to clinicians. The majority of the systems were capable of performing almost all of the key knowledge management functions we identified.
If these well-designed commercially-available systems are coupled with the other key socio-technical concepts required for safe and effective EHR implementation and use, and organizations have access to implementable clinical knowledge, we expect that the transformation of the healthcare enterprise that so many have predicted, is achievable using commercially-available, state-of-the-art EHRs.
我们开展了一项广泛的定性研究计划，重点研究在具有长期电子病历（EHR）研究和开发计划的大型学术教学机构中，成功采用和使用各种先进的、最先进的电子健康记录（EHR）功能的障碍和促进因素。我们最近开始调查依赖商业可用 EHR 的较小的社区医院和门诊诊所。我们试图评估当前一代商业可用的 EHR 是否能够提供提供和维护临床决策支持（CDS）干预所需的临床知识管理功能、功能、工具和技术，以支持最近定义的“有意义的使用”标准。
我们为九家商业上可用的 EHR 供应商和四家领先的内部开发的 EHR 的代表开发并实施了一项 17 个问题的调查。调查的第一部分询问了供应商 EHR 的基本问题。第二部分专门询问了每个供应商提供的与 CDS 相关的系统工具和功能。最后一节询问了临床内容。
所有供应商和机构都有多个模块，能够为临床医生提供临床决策支持干预。大多数系统能够执行我们确定的几乎所有关键知识管理功能。
如果这些设计良好的商业上可用的系统与安全有效的 EHR 实施和使用所需的其他关键社会技术概念相结合，并且组织能够获得可实施的临床知识，我们预计许多人预测的医疗保健企业的转型是可以实现的使用商业上可用的最先进的 EHR。
