Health Services Research & Development (HSR&D) Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA.
J Gen Intern Med. 2011 Nov;26 Suppl 2(Suppl 2):623-7. doi: 10.1007/s11606-011-1789-3.
The Department of Veterans Affairs (VA) has been at the vanguard of information technology (IT) and use of comprehensive electronic health records. Despite the widespread use of health IT in the VA, there are still a variety of key questions that need to be answered in order to maximize the utility of IT to improve patient access to quality services. This paper summarizes the potential of IT to enhance healthcare access, key gaps in current evidence linking IT and access, and methodologic challenges for related research. We also highlight four key issues to be addressed when implementing and evaluating the impact of IT interventions on improving access to quality care: 1) Understanding broader needs/perceptions of the Veteran population and their caregivers regarding use of IT to access healthcare services and related information. 2) Understanding individual provider/clinician needs/perceptions regarding use of IT for patient access to healthcare. 3) System/Organizational issues within the VA and other organizations related to the use of IT to improve access. 4) IT integration and information flow with non-VA entities. While the VA is used as an example, the issues are salient for healthcare systems that are beginning to take advantage of IT solutions.
美国退伍军人事务部（VA）一直处于信息技术（IT）和全面电子健康记录使用的前沿。尽管 VA 广泛使用了医疗信息技术，但仍有许多关键问题需要回答，以便最大限度地利用 IT 提高患者获得优质服务的机会。本文总结了 IT 增强医疗保健可及性的潜力、当前将 IT 与可及性联系起来的证据中的关键差距，以及相关研究的方法学挑战。我们还强调了在实施和评估 IT 干预措施对改善获得优质护理的影响时需要解决的四个关键问题：1）了解退伍军人及其护理人员更广泛的使用 IT 访问医疗保健服务和相关信息的需求/看法。2）了解个人提供者/临床医生在使用 IT 为患者获取医疗保健方面的需求/看法。3）VA 内部以及其他与使用 IT 改善可及性相关的组织/组织问题。4）与非 VA 实体的 IT 集成和信息流。虽然 VA 被用作一个例子，但对于那些开始利用 IT 解决方案的医疗保健系统来说，这些问题是很重要的。
