Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Health Policy and Technology Assessment, National Institute of Public Health 2-3-6 Minami, Wako, Saitama 351-0197, Japan.
Am J Emerg Med. 2014 Jul;32(7):725-30. doi: 10.1016/j.ajem.2014.03.035. Epub 2014 Mar 28.
Although electronic health record systems (EHRs) and emergency department information systems (EDISs) enable safe, efficient, and high-quality care, these systems have not yet been studied well. Here, we assessed (1) the prevalence of EHRs and EDISs, (2) changes in efficiency in emergency medical practices after introducing EHR and EDIS, and (3) barriers to and expectations from the EHR-EDIS transition in EDs of medical facilities with EHRs in Japan.
A survey regarding EHR (basic or comprehensive) and EDIS implementation was mailed to 466 hospitals. We examined the efficiency after EHR implementation and perceived barriers and expectations regarding the use of EDIS with existing EHRs. The survey was completed anonymously.
Totally, 215 hospitals completed the survey (response rate, 46.1%), of which, 76.3% had basic EHRs, 4.2% had comprehensive EHRs, and 1.9% had EDISs. After introducing EHRs and EDISs, a reduction in the time required to access previous patient information and share patient information was noted, but no change was observed in the time required to produce medical records and the overall time for each medical care. For hospitals with EHRs, the most commonly cited barriers to EDIS implementation were inadequate funding for adoption and maintenance and potential adverse effects on workflow. The most desired function in the EHR-EDIS transition was establishing appropriate clinical guidelines for residents within their system.
To attract EDs to EDIS from EHR, systems focusing on decreasing the time required to produce medical records and establishing appropriate clinical guidelines for residents are required.
尽管电子健康记录系统（EHRs）和急诊部门信息系统（EDISs）能够实现安全、高效和高质量的医疗服务，但这些系统尚未得到充分研究。在此，我们评估了：(1) EHRs 和 EDIS 的普及情况；(2) 在引入 EHR 和 EDIS 后，急诊医疗实践效率的变化；(3) 在日本已经配备 EHR 的医疗机构的急诊部门中，EHR-EDIS 转换的障碍和期望。
我们向 466 家医院邮寄了一份关于 EHR（基础或综合）和 EDIS 实施情况的调查。我们检查了 EHR 实施后的效率，以及对使用现有 EHR 的 EDIS 的感知障碍和期望。该调查是匿名完成的。
共有 215 家医院完成了调查（应答率为 46.1%），其中 76.3%的医院配备了基础 EHR，4.2%的医院配备了综合 EHR，1.9%的医院配备了 EDIS。在引入 EHR 和 EDIS 后，访问以前患者信息和共享患者信息所需的时间有所减少，但制作病历和每次医疗护理的总时间没有变化。对于配备 EHR 的医院，实施 EDIS 的最常见障碍是采用和维护资金不足以及对工作流程可能产生的不利影响。EHR-EDIS 转换中最需要的功能是在其系统内为住院医师建立适当的临床指南。
为了吸引 ED 采用 EDIS，需要专注于减少制作病历所需的时间并为住院医师建立适当的临床指南的系统。
