Chae Young Moon, Yoo Ki Bong, Kim Eun Sook, Chae Hogene
Department of Health Informatics, Graduate School of Public Health, Yonsei University, Seoul, Korea.
Healthc Inform Res. 2011 Sep;17(3):172-7. doi: 10.4258/hir.2011.17.3.172. Epub 2011 Sep 30.
To examine the current status of hospital information systems (HIS), analyze the effects of Electronic Medical Records (EMR) and Clinical Decision Support Systems (CDSS) have upon hospital performance, and examine how management issues change over time according to various growth stages.
Data taken from the 2010 survey on the HIS status and management issues for 44 tertiary hospitals and 2009 survey on hospital performance appraisal were used. A chi-square test was used to analyze the association between the EMR and CDSS characteristics. A t-test was used to analyze the effects of EMR and CDSS on hospital performance.
Hospital size and top management support were significantly associated with the adoption of EMR. Unlike the EMR results, however, only the standardization characteristic was significantly associated with CDSS adoption. Both EMR and CDSS were associated with the improvement of hospital performance. The EMR adoption rates and outsourcing consistently increased as the growth stage increased. The CDSS, Knowledge Management System, standardization, and user training adoption rates for Stage 3 hospitals were higher than those found for Stage 2 hospitals.
Both EMR and CDSS influenced the improvement of hospital performance. As hospitals advanced to Stage 3, i.e. have more experience with information systems, they adopted EMRs and realized the importance of each management issue.
考察医院信息系统(HIS)的现状,分析电子病历(EMR)和临床决策支持系统(CDSS)对医院绩效的影响,并研究管理问题如何根据不同的发展阶段随时间变化。
使用了2010年对44家三级医院HIS现状及管理问题的调查数据以及2009年医院绩效评估调查数据。采用卡方检验分析EMR和CDSS特征之间的关联。采用t检验分析EMR和CDSS对医院绩效的影响。
医院规模和高层管理支持与EMR的采用显著相关。然而,与EMR的结果不同,只有标准化特征与CDSS的采用显著相关。EMR和CDSS均与医院绩效的改善相关。随着发展阶段的增加,EMR的采用率和外包率持续上升。三级医院的CDSS、知识管理系统、标准化和用户培训采用率高于二级医院。
EMR和CDSS均影响医院绩效的改善。随着医院发展到第三阶段,即对信息系统有更多经验时,它们采用了EMR并认识到每个管理问题的重要性。