Department of Biomedical Informatics, Columbia University, 622 West 168th St, New York, NY 10032, USA.
Appl Clin Inform. 2012 Jul 18;3(3):290-300. doi: 10.4338/ACI-2011-03-RA-0019. Print 2012.
We designed and implemented an electronic patient tracking system with improved user authentication and patient selection. We then measured access to clinical information from previous clinical encounters before and after implementation of the system. Clinicians accessed longitudinal information for 16% of patient encounters before, and 40% of patient encounters after the intervention, indicating such a system can improve clinician access to information. We also attempted to evaluate the impact of providing this access on inpatient admissions from the emergency department, by comparing the odds of inpatient admission from an emergency department before and after the improved access was made available. Patients were 24% less likely to be admitted after the implementation of improved access. However, there were many potential confounders, based on the inherent pre-post design of the evaluation. Our experience has strong implications for current health information exchange initiatives.
我们设计并实施了一个电子患者跟踪系统，改进了用户认证和患者选择功能。然后，我们测量了在实施该系统前后从之前的临床就诊中获取临床信息的情况。在干预之前，临床医生可以访问 16%的患者就诊的纵向信息，而在干预之后，可以访问 40%的患者就诊的纵向信息，这表明这样的系统可以改善临床医生获取信息的能力。我们还试图通过比较改善访问权限前后从急诊科入院的住院患者的可能性，来评估提供这种访问权限对从急诊科入院的影响。在实施改进的访问权限后，患者入院的可能性降低了 24%。然而，基于评估的固有前后设计，存在许多潜在的混杂因素。我们的经验对当前的健康信息交换计划具有重要意义。
