健康信息技术的影响随时间而变化：一项关于远程 ICU 功能的研究。
The effects of health information technology change over time: a study of Tele-ICU functions.
机构信息
Center for Research & Innovation in Systems Safety, Vanderbilt University Medical Center (VUMC) , Nashville, TN 37209, USA.
出版信息
Appl Clin Inform. 2012 Jun 27;3(2):239-47. doi: 10.4338/ACI-2011-12-RA-0073. Print 2012.
OBJECTIVES
Longitudinal studies exploring the evolution of health information technology functions provide valuable information about how technology systems are integrated and exploited in situ. This study reports changes in the distribution of functions for a specific health information technology, the tele-ICU, over time. The studied tele-ICU provided care to six remote ICUs within a local geographic region in the same state and had nursing staff around the clock.
METHODS
The intervention logs of tele-ICU nurses were collected during two discrete times and coded into nine emergent functional categories, who initiated the intervention and, if required, subsequent escalation. All coded functional categories were investigated for significant changes over time in the nursing logged interventions.
RESULTS
A total of 1927 interventions were coded into the nine emergent functional categories. Seven of the nine categories (78%) were significantly different between 2005 and 2007. The functions of the tele-ICU system continue to change and develop over time.
CONCLUSION
These findings suggest that the tele-ICU increased support when ICU nurses were off the unit, inter-hospital coordinating and adherence to best practices, while simultaneously decreasing real-time support for ICU nurses. This research suggests that sustaining safety features in a new technology over time have post-conditions after implementation.
目的
探索健康信息技术功能演变的纵向研究提供了有价值的信息，说明技术系统是如何在现场进行整合和利用的。本研究报告了特定的健康信息技术（远程 ICU）的功能分布随时间的变化。所研究的远程 ICU 为同一州内同一地理区域的六个远程 ICU 提供护理，并有护理人员 24 小时值班。
方法
在两个不同的时间收集远程 ICU 护士的干预日志，并将其编码为九个紧急功能类别，这些类别记录了发起干预的人员，如果需要，还记录了后续的升级情况。对所有编码的功能类别进行了调查，以了解护理记录的干预措施在时间上是否有显著变化。
结果
共对 1927 项干预措施进行了编码，分为九个紧急功能类别。九个类别中有七个（78%）在 2005 年和 2007 年之间存在显著差异。远程 ICU 系统的功能随着时间的推移继续发生变化和发展。
结论
这些发现表明，远程 ICU 增加了 ICU 护士不在病房时的支持、医院间的协调和对最佳实践的遵守，同时减少了对 ICU 护士的实时支持。这项研究表明，随着时间的推移，新技术中的安全功能具有实施后的后续条件。
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