Bernd David L, Fine Peter S
Sentara Healthcare, Norfolk, Virginia, USA.
Front Health Serv Manage. 2011 Fall;28(1):3-13.
Health systems are moving to implement comprehensive electronic medical record (EMR) systems, or significant pieces of them, in the belief that EMR can be integrated into clinical practice and lead to improved patient outcomes and enhanced safety. There are substantial roadblocks to implementing EMR, including significant cost, the competency needed to implement, the political environment, organization infrastructure and culture, and how organization leaders understand return on investment. Complicating factors include the drive to implement EMR to meet meaningful use standards to qualify for a federal incentive program and recently publicized studies that question the value equation of the EMR as it relates to patient care improvements. We offer our experiences on the successful implementation of the EMR across the large health systems we lead. We offer practical advice and tips on how to achieve successful implementation, evidence that successful implementations improve patient care and safety, and a glimpse of how EMR is a significant foundation in a future of collaborative models that provide continuum-based care.
卫生系统正在着手实施全面的电子病历（EMR）系统或其中的重要部分，因为他们相信电子病历能够融入临床实践，进而改善患者治疗效果并提高安全性。实施电子病历存在诸多障碍，包括高昂的成本、实施所需的能力、政治环境、组织基础设施和文化，以及组织领导者对投资回报率的理解。复杂因素还包括为符合联邦激励计划资格而推动实施电子病历以满足有意义使用标准，以及最近公布的一些研究，这些研究对电子病历与改善患者护理相关的价值等式提出了质疑。我们分享在我们所领导的大型卫生系统中成功实施电子病历的经验。我们提供关于如何实现成功实施的实用建议和提示、成功实施可改善患者护理和安全的证据，以及对电子病历如何成为未来提供基于连续护理的协作模式的重要基础的一瞥。
