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电子病历和临床决策支持系统在抗菌药物管理中的应用。

Use of electronic health records and clinical decision support systems for antimicrobial stewardship.

机构信息

Division of Infectious Diseases, Portland Veterans Affairs Medical Center, Portland, Oregon.

University of Nebraska Medical Center, Omaha.

出版信息

Clin Infect Dis. 2014 Oct 15;59 Suppl 3:S122-33. doi: 10.1093/cid/ciu565.

Abstract

Electronic health records (EHRs) and clinical decision support systems (CDSSs) have the potential to enhance antimicrobial stewardship. Numerous EHRs and CDSSs are available and have the potential to enable all clinicians and antimicrobial stewardship programs (ASPs) to more efficiently review pharmacy, microbiology, and clinical data. Literature evaluating the impact of EHRs and CDSSs on patient outcomes is lacking, although EHRs with integrated CDSSs have demonstrated improvements in clinical and economic outcomes. Both technologies can be used to enhance existing ASPs and their implementation of core ASP strategies. Resolution of administrative, legal, and technical issues will enhance the acceptance and impact of these systems. EHR systems will increase in value when manufacturers include integrated ASP tools and CDSSs that do not require extensive commitment of information technology resources. Further research is needed to determine the true impact of current systems on ASP and the ultimate goal of improved patient outcomes through optimized antimicrobial use.

摘要

电子健康记录 (EHR) 和临床决策支持系统 (CDSS) 有可能增强抗菌药物管理。有许多 EHR 和 CDSS 可供使用,有可能使所有临床医生和抗菌药物管理项目 (ASP) 更有效地审查药房、微生物学和临床数据。虽然具有集成 CDSS 的 EHR 已经证明在临床和经济结果方面有所改善,但缺乏评估 EHR 和 CDSS 对患者结果影响的文献。这两种技术都可用于增强现有的 ASP 及其实施的核心 ASP 策略。解决行政、法律和技术问题将增强这些系统的接受度和影响力。当制造商包括不需要大量信息技术资源投入的集成 ASP 工具和 CDSS 时,EHR 系统的价值将会增加。需要进一步研究以确定当前系统对 ASP 的实际影响以及通过优化抗菌药物使用提高患者结果的最终目标。

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