Information Center for Decisions in Public Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
J Am Med Inform Assoc. 2013 Mar-Apr;20(2):238-44. doi: 10.1136/amiajnl-2012-000907. Epub 2012 Sep 27.
The findings of a case study assessing the design and implementation of an electronic health record (EHR) in the public health system of Colima, Mexico, its perceived benefits and limitations, and recommendations for improving the implementation process are presented. In-depth interviews and focus group discussions were used to examine the experience of the actors and stakeholders participating in the design and implementation of EHRs. Results indicate that the main driving force behind the use of EHRs was to improve reporting to the two of the main government health and social development programs. Significant challenges to the success of the EHR include resistance by physicians to use the ICD-10 to code diagnoses, insufficient attention to recurrent resources needed to maintain the system, and pressure from federal programs to establish parallel information systems. Operating funds and more importantly political commitment are required to ensure sustainability of the EHRs in Colimaima.
呈现了一项评估电子健康记录 (EHR) 在墨西哥科利马公共卫生系统中的设计和实施情况、其感知到的益处和局限性的案例研究的结果，并提出了改进实施过程的建议。采用深入访谈和焦点小组讨论的方法，考察了参与 EHR 设计和实施的行为者和利益相关者的经验。结果表明，使用 EHR 的主要驱动力是改善向两个主要政府卫生和社会发展计划的报告。EHR 成功的主要挑战包括医生对使用 ICD-10 对诊断进行编码的抵制、对维持系统所需的经常性资源的关注不足，以及联邦计划对建立并行信息系统的压力。需要运营资金，更重要的是需要政治承诺，以确保科利马的 EHR 可持续发展。
