Temple University School of Medicine, 7604 Central Avenue, Philadelphia, PA, 19111-2442, USA,
Curr Oncol Rep. 2013 Dec;15(6):588-94. doi: 10.1007/s11912-013-0347-z.
The implementation of electronic medical records (EMR) systems was mandated by the U.S. federal government in large part due to research indicating that difficulty accessing clinical data was one of the most common causes of preventable deaths. Several assumptions were implicit in this mandate, including the assumption that the implementation of EMR would indeed improve clinicians' access to clinical data, that implementation of EMR would pose little to no risk to patients, and that the clinical benefit of improved access to clinical data would outweigh any risks that might arise. As detailed in this review, both formal research and extensive experiential observation have called all three assumptions into question. Specifically, as detailed below, there is clear evidence that EMR systems are associated with multiple specific risks to patients, whereas few, if any, scientifically rigorous outcomes-based studies have demonstrated that the potential benefits of EMR outweigh the known risks. In addition, there is currently little to no scientifically rigorous evidence that EMR systems constitute a cost-effective methodology for improving patient outcomes.
电子病历(EMR)系统的实施很大程度上是由美国联邦政府强制要求的,主要是因为有研究表明,难以获取临床数据是导致可预防死亡的最常见原因之一。这项任务隐含了几个假设,包括实施 EMR 确实会改善临床医生获取临床数据的途径、实施 EMR 对患者几乎没有风险、以及改善获取临床数据的临床效益将超过可能出现的任何风险。正如本综述所详细说明的,正式研究和广泛的经验观察都对这三个假设提出了质疑。具体来说,如下所述,有明确的证据表明 EMR 系统与患者面临的多种特定风险相关,而几乎没有(如果有的话)经过严格科学验证的基于结果的研究表明,EMR 的潜在益处超过了已知的风险。此外,目前几乎没有经过严格科学验证的证据表明 EMR 系统是改善患者预后的一种具有成本效益的方法。