Department of Anesthesiology and Critical Care Medicine, Hadassah-Hebrew University Medical Center, Hebrew University-Hadassah School of Medicine, Jerusalem, Israel.
Int J Med Inform. 2012 Mar;81(3):173-81. doi: 10.1016/j.ijmedinf.2011.12.009. Epub 2012 Jan 13.
Use of an anesthesia information management system (AIMS) does not insure record completeness and data accuracy. Mandatory data-entry fields can be used to assure data completeness. However, they are not suited for data that is mandatory depending on the clinical situation (context sensitive). For example, information on equal breath sounds should be mandatory with tracheal intubation, but not with mask ventilation. It was hypothesized that employing context-sensitive mandatory data-entry fields can insure high data-completeness and accuracy while maintaining usability.
A commercial off-the-shelf AIMS was enhanced using its built-in VBScript programming tool to build event-driven forms with context-sensitive mandatory data-entry fields. One year after introduction of the system, all anesthesia records were reviewed for data completeness. Data concordance, used as a proxy for accuracy, was evaluated using verifiable age-related data. Additionally, an anonymous satisfaction survey on general acceptance and usability of the AIMS was performed.
During the initial 12 months of AIMS use, 12,241 (99.6%) of 12,290 anesthesia records had complete data. Concordances of entered data (weight, size of tracheal tubes, laryngoscopy blades and intravenous catheters) with patients' ages were 98.7-99.9%. The AIMS implementation was deemed successful by 98% of the anesthesiologists. Users rated the AIMS usability in general as very good and the data-entry forms in particular as comfortable.
Due to the complexity and the high costs of implementation of an anesthesia information management system it was not possible to compare various system designs (for example with or without context-sensitive mandatory data entry-fields). Therefore, it is possible that a different or simpler design would have yielded the same or even better results. This refers also to the evaluation of usability, since users did not have the opportunity to work with different design approaches or even different computer programs.
Using context-sensitive mandatory fields in an anesthesia information management system was associated with high record completeness rate and data concordance. In addition, the system's usability was rated as very good by its users.
使用麻醉信息管理系统（AIMS）并不能保证记录的完整性和数据的准确性。强制性数据输入字段可用于确保数据的完整性。然而，它们并不适用于取决于临床情况的强制性数据（上下文敏感）。例如，气管插管时应强制性录入双侧呼吸音相同的信息，但在使用面罩通气时则非强制性。假设使用上下文敏感的强制性数据输入字段可以在保持可用性的同时确保数据的高度完整性和准确性。
使用其内置的 VBScript 编程工具，对一款商用现成的 AIMS 进行增强，构建具有上下文敏感强制性数据输入字段的事件驱动表单。在系统引入一年后，对所有的麻醉记录进行数据完整性审查。使用可验证的与年龄相关的数据评估数据一致性，以作为准确性的替代指标。此外，还对 AIMS 的总体接受度和可用性进行了匿名满意度调查。
在使用 AIMS 的最初 12 个月中，12290 份麻醉记录中有 12241 份（99.6%）记录完整。输入数据（体重、气管导管、喉镜叶片和静脉导管的大小）与患者年龄的一致性为 98.7-99.9%。98%的麻醉师认为 AIMS 的实施是成功的。用户普遍认为 AIMS 的可用性非常好，特别是数据输入表单非常舒适。
由于麻醉信息管理系统的复杂性和实施成本较高，无法比较各种系统设计（例如，有无上下文敏感的强制性数据输入字段）。因此，可能采用不同或更简单的设计也会产生相同甚至更好的结果。这也适用于可用性的评估，因为用户没有机会使用不同的设计方法，甚至不同的计算机程序。
在麻醉信息管理系统中使用上下文敏感的强制性字段与高记录完整性率和数据一致性相关。此外，用户对该系统的可用性评价非常好。
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