Department of Emergency Medicine, Indiana University, Indianapolis, IN, USA.
Ann Emerg Med. 2011 Jul;58(1 Suppl 1):S71-3.e1. doi: 10.1016/j.annemergmed.2011.03.028.
We describe electronic medical record use in automated eligibility determination for an emergency department (ED)-based nontargeted HIV screening program.
We reviewed the electronic medical record system at an urban, inner-city ED from March 17 to April 14, 2008. During that period, patient eligibility for HIV screening was electronically determined according to preprogrammed criteria: (1) age between 18 and 64 years; (2) no known history of HIV disease; and (3) no known HIV screening in the previous year. This populated an electronic work list used by HIV testing counselors.
Of 8,489 ED patients during the study period, the electronic medical record system determined 5,794 (68.3%) as eligible. Of 1,484 (25.6%) patients approached for screening, 1,121 (75.5%) consented, and 5 received confirmed positive results (0.4%). Reasons for ineligibility, as determined by the electronic medical record system, were previous screening 1,125 (41.7%), age 890 (33.0%), known HIV 111 (4.1%), and reason unknown 569 (21.1%).
Clinical informatics solutions can provide automated delineation of ED subpopulations eligible for HIV screening, according to predetermined criteria, which could increase program efficiency and might accelerate integration of HIV screening into clinical practice.
我们描述了电子病历在基于急诊科的非目标性 HIV 筛查项目的自动资格确定中的使用情况。
我们回顾了 2008 年 3 月 17 日至 4 月 14 日期间，一家城市中心区急诊科的电子病历系统。在此期间，根据预先设定的标准，通过电子方式确定患者是否有资格进行 HIV 筛查：（1）年龄在 18 至 64 岁之间；（2）无已知的 HIV 病史；（3）前一年无已知的 HIV 筛查。这将填充用于 HIV 检测顾问的电子工作清单。
在研究期间，8489 名急诊科患者中，电子病历系统确定了 5794 名（68.3%）符合条件。在对 1484 名（25.6%）患者进行筛查时，有 1121 名（75.5%）同意，5 名患者获得了确诊阳性结果（0.4%）。电子病历系统确定的不合格原因包括：前次筛查 1125 名（41.7%）、年龄 890 名（33.0%）、已知 HIV 111 名（4.1%）和原因不明 569 名（21.1%）。
临床信息学解决方案可以根据预定标准提供自动划定急诊科符合 HIV 筛查条件的亚人群，这可以提高项目效率，并可能加速 HIV 筛查纳入临床实践。
