Department of Anesthesiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA.
J Clin Monit Comput. 2011 Apr;25(2):129-35. doi: 10.1007/s10877-011-9289-x. Epub 2011 Jul 5.
Electronic medical records (EMR) may increase the safety and efficiency of healthcare. Anesthesia care is a significant component of the perioperative period, yet little is known about the adoption of anesthesia information management systems (AIMS) by US anesthesiologists, particularly in non-academic settings. Herein, we report the results of a survey of US anesthesiologists regarding adoption of AIMS and anesthesiologist-perceived advantages and barriers to AIMS adoption.
Using the e-mail database of the American Society of Anesthesiologists, we solicited randomly selected US anesthesiologists to participate in a survey of their AIMS adoption, perceived advantages and barriers to AIMS. Two and then 3 weeks after the initial mailing, a follow-up e-mail was sent to each anesthesiologist. The study was closed 4 weeks after the initial mailing.
Five thousand anesthesiologists were solicited; 615 (12.3%) responses were received. Twenty-four percent of respondents had installed an AIMS, while 13% were either installing a system now or had selected one, and an additional 13% were actively searching. Larger anesthesiology groups with large case loads, urban settings, and government affiliated or academic institutions were more likely to have adopted AIMS. Initial cost was the most frequently cited AIMS barrier. The most commonly cited benefit was more accurate clinical documentation (79%), while unanticipated need for ongoing information technology support (49%) and difficult integration of AIMS with an existing EMR (61%) were the most commonly cited problems. There were no barriers cited significantly more often by non-adopters than adopters.
At least 50% of our survey respondents were currently using, installing, planning to install, or searching for an AIMS. However, the strength of any conclusion is undermined by a low survey response rate and potential bias as respondents using or searching for an AIMS may be more likely to participate. Nonetheless, challenges exist for anesthesiologists considering AIMS adoption including cost. Furthermore, important questions remain regarding payment for anesthesia services and the relationship of AIMS and "meaningful use" as defined by the Centers for Medicare & Medicaid Services.
电子病历（EMR）可能会提高医疗保健的安全性和效率。麻醉护理是围手术期的重要组成部分，但人们对美国麻醉师采用麻醉信息管理系统（AIMS）的情况知之甚少，特别是在非学术环境中。在此，我们报告了一项针对美国麻醉师采用 AIMS 情况以及麻醉师对采用 AIMS 的优势和障碍的调查结果。
我们使用美国麻醉师协会的电子邮件数据库，随机邀请美国麻醉师参与一项关于他们采用 AIMS 的调查，以及他们对采用 AIMS 的优势和障碍的看法。在首次邮寄后的第 2 周和第 3 周，向每位麻醉师发送了一封后续电子邮件。该研究在首次邮寄后 4 周结束。
我们邀请了 5000 名麻醉师，收到了 615 份（12.3%）的回复。24%的受访者已经安装了 AIMS，而 13%的受访者正在安装或已经选择了一个系统，还有 13%的受访者正在积极寻找。拥有较大病例量、位于城市地区、与政府有关联或属于学术机构的较大规模麻醉科更有可能采用 AIMS。初始成本是最常被提及的 AIMS 障碍。最常被提及的好处是更准确的临床文档记录（79%），而意想不到的对持续信息技术支持的需求（49%）以及 AIMS 与现有电子病历（61%）集成困难是最常被提及的问题。非使用者提出的障碍并不比使用者更常见。
我们调查的至少 50%的受访者目前正在使用、安装、计划安装或正在寻找 AIMS。然而，由于调查回复率低且存在潜在偏差，任何结论的可信度都受到了影响，因为正在使用或寻找 AIMS 的受访者可能更愿意参与调查。尽管如此，对于考虑采用 AIMS 的麻醉师来说，仍然存在一些挑战，包括成本问题。此外，关于麻醉服务的支付以及医疗保险和医疗补助服务中心（CMS）定义的 AIMS 和“有意义使用”之间的关系，仍存在重要问题。
