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急诊科健康信息交换经济效益的实证分析。

An empirical analysis of the financial benefits of health information exchange in emergency departments.

作者信息

Yaraghi Niam

机构信息

Center for Technology Innovation, Governance Studies, The Brookings Institution, 1775 Massachusetts Ave. NW, Washington, DC 20036, USA

出版信息

J Am Med Inform Assoc. 2015 Nov;22(6):1169-72. doi: 10.1093/jamia/ocv068. Epub 2015 Jun 27.

Abstract

OBJECTIVE

To examine the impact of health information exchange (HIE) on reducing laboratory tests and radiology examinations performed in an emergency department (ED).

MATERIALS AND METHODS

The study was conducted in an ED setting in Western New York over a period of 2 months. The care of the patients in the treatment group included an HIE query for every encounter, while the care of other patients in the control group did not include such queries. A group of medical liaisons were hired to query the medical history of patients from an HIE and provide it to the ED clinicians. Negative binomial regression was used to analyze the effects of HIE queries on the number of performed laboratory tests and radiology examinations. The log files of the HIE system since 1 year before the ED admission were used to analyze the differences in outcome measures between the 2 groups of patients.

RESULTS

Ceteris paribus, HIE usage is associated with, respectively, 52% and 36% reduction in the expected total number of laboratory tests and radiology examinations ordered per patient at the ED.

CONCLUSIONS

The results indicate that access to additional clinical data through the HIE will significantly reduce the number of laboratory tests and radiology examinations performed in the ED settings and thus support the ongoing HIE efforts.

摘要

目的

探讨健康信息交换(HIE)对减少急诊科(ED)进行的实验室检查和放射学检查的影响。

材料与方法

该研究在纽约西部的一个急诊科进行,为期2个月。治疗组患者的护理包括每次就诊时进行HIE查询,而对照组其他患者的护理不包括此类查询。雇佣了一组医疗联络人员从HIE查询患者的病史并提供给急诊科临床医生。使用负二项回归分析HIE查询对所进行的实验室检查和放射学检查数量的影响。使用急诊科入院前1年以来的HIE系统日志文件分析两组患者在结局指标上的差异。

结果

在其他条件相同的情况下,使用HIE分别使急诊科每位患者的预期实验室检查和放射学检查总数减少52%和36%。

结论

结果表明,通过HIE获取额外的临床数据将显著减少急诊科进行的实验室检查和放射学检查数量,从而支持正在进行的HIE工作。

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