Anesthesia Medical Group, PC, Nashville, TN, USA.
Can J Anaesth. 2013 Feb;60(2):119-26. doi: 10.1007/s12630-012-9851-0. Epub 2012 Dec 8.
The adoption of new technologies in medicine is frequently met with both enthusiasm and resistance. The universal adoption of health information technology (IT) and anesthesia information management systems (AIMS) remains low despite the potential benefits. Electronic medical records, and hence AIMS, are at the intersection of patient safety. This article highlights advantages and barriers to adoption and implementation of IT in general and AIMS in particular, with a focus on clinical decision support systems (CDSS) and computerized physician order entry (CPOE) as hallmarks that may lead to improvement in patient safety and quality in the perioperative setting.
The advantages of health IT and AIMS include improved legibility of documentation; the ability to integrate new scientific evidence into practice; enhanced management and exchange of complex health information; the ability to standardize order sets, incorporate computerized physician order entry, and provide clinical decision support; and the ability to capture data for management, research, and quality monitoring and reporting. While not foolproof, AIMS have been shown to improve safety, quality, and patient outcomes. Barriers to the adoption of health IT and AIMS include costs, lack of truly interoperable AIMS components in health-system IT solutions, and lack of clinician involvement in implementation, planning, design, and installation of many IT or AIMS products.
Health IT and AIMS are at the intersection of patient safety and technology. Anesthesiologists are perfectly positioned to be the physician leaders of adoption, design, implementation, and integration, not only for AIMS but also for health-system IT solutions in general.
新的医学技术在应用过程中,通常会同时受到欢迎和抵制。尽管有潜在的益处,但健康信息技术(IT)和麻醉信息管理系统(AIMS)的普遍采用率仍然很低。电子病历,以及因此 AIMS,处于患者安全的交叉点。本文重点介绍了一般信息技术和特别是 AIMS 的采用和实施的优势和障碍,重点关注临床决策支持系统(CDSS)和计算机化医师医嘱录入(CPOE),这可能会改善围手术期患者的安全和质量。
健康 IT 和 AIMS 的优势包括提高文档的可读性;将新的科学证据整合到实践中的能力;增强对复杂健康信息的管理和交换;能够标准化医嘱集、纳入计算机化医师医嘱录入并提供临床决策支持;以及能够为管理、研究、质量监测和报告捕获数据。虽然不是万无一失的,但 AIMS 已被证明可以提高安全性、质量和患者结果。健康 IT 和 AIMS 采用的障碍包括成本、医疗系统 IT 解决方案中真正互操作的 AIMS 组件缺乏以及临床医生在许多 IT 或 AIMS 产品的实施、规划、设计和安装中缺乏参与。
健康 IT 和 AIMS 处于患者安全和技术的交叉点。麻醉师非常适合成为采用、设计、实施和整合的医师领导者,不仅是 AIMS,还包括一般医疗系统 IT 解决方案。