School of Health Information Science, University of Victoria, PO Box 3050, STN CSC, Victoria, British Columbia V8W 3P5, Canada.
Int J Med Inform. 2013 May;82(5):e149-60. doi: 10.1016/j.ijmedinf.2012.12.006. Epub 2013 Jan 10.
In this paper we review progress as well as challenges encountered in Canada, the United States and England with regard to ensuring safety of health information technology.
A review of major programs and initiatives for ensuring safety of health information technology in the three countries was conducted. Published literature and Web resources from national programs were reviewed for relevant information.
It was found that in all three countries the issue of technology-induced error has been recognized as being of critical importance. The three countries have developed approaches for dealing with the issue that have some commonalities; however, they are at varying different stages of maturity, with England having the longest standing and most well developed safety programs, while Canada and the United States are at earlier stages. The types of approaches employed have included work on developing standards related to usability and interface design, certifications, directives from regulatory bodies, educational initiatives in health information technology (HIT) safety as well as research into safer HIT design and implementation methods.
HIT promises to lead to improved patient safety. However, it has become recognized that if not designed and deployed appropriately, such systems can lead to new types of errors. Based on this recognition, a variety of initiatives are being undertaken in Canada, the United States and England to promote the safe design, procurement and deployment of HIT. It is concluded that improved approaches to system design, testing, regulation, error reporting, safety education and cross-country collaboration will be needed to further promote safer HIT.
本文回顾了加拿大、美国和英国在确保医疗信息技术安全方面所取得的进展和面临的挑战。
对这三个国家为确保医疗信息技术安全而开展的主要计划和举措进行了审查。查阅了国家计划的相关出版物和网络资源，以获取相关信息。
研究发现，在这三个国家，技术导致的错误问题已被视为至关重要。这三个国家已经制定了一些具有共同特点的方法来处理这一问题，但它们所处的成熟阶段不同，英国的安全计划历史最久、最为完善，而加拿大和美国处于早期阶段。所采用的方法包括开发与可用性和界面设计相关的标准、认证、监管机构指令、医疗信息技术（HIT）安全方面的教育举措以及更安全的 HIT 设计和实施方法的研究。
HIT 有望提高患者安全性。然而，人们已经认识到，如果设计和部署不当，这些系统可能会导致新的错误类型。基于这一认识，加拿大、美国和英国正在采取各种举措，以促进 HIT 的安全设计、采购和部署。研究得出结论，需要改进系统设计、测试、监管、错误报告、安全教育和跨国合作等方法，以进一步促进更安全的 HIT。
