Kashani Kianoush, Herasevich Vitaly
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minn., USA.
Nephron. 2015;131(2):92-6. doi: 10.1159/000437311. Epub 2015 Sep 30.
Electronic health records (EHRs) have become an integrated part of medical practice in most clinical settings around the world. Appropriate use of EHR potentially improves patient care while poorly designed EHR can cause harm. In recent years, EHR has been used as a platform to identify patients who have or may develop acute kidney injury (AKI). The benefit of using EHR for a rule-based classification of AKI has been controversial. While some reports indicate improvement in the process of care provided to AKI patients, other studies do not show significant changes in the outcomes. Utilities of EHR in AKI should go beyond a rule-based detection of the AKI as a syndrome. There are several different potential applications for such tools including AKI forecasting models and clinical decision support systems, to improve the quality of care and outcome of the patients with AKI. Both clinical and investigative interest in the field is growing among clinicians, administrators and scientists. Appropriate utilization of intelligent EHR can provide timely, appropriate and accurate information to the clinicians in order to improve the quality of care provided to critically ill patients and assist investigators to generate new knowledge. In this review paper, we discuss the past and present states of EHR role in the field of AKI. We also share our views regarding the future potentials and directions of these devices.
电子健康记录(EHRs)已成为全球大多数临床环境中医疗实践的一个组成部分。合理使用电子健康记录有可能改善患者护理,而设计不佳的电子健康记录可能会造成伤害。近年来,电子健康记录已被用作识别患有或可能发生急性肾损伤(AKI)患者的平台。使用电子健康记录对急性肾损伤进行基于规则的分类的益处一直存在争议。虽然一些报告表明为急性肾损伤患者提供的护理过程有所改善,但其他研究并未显示出结果有显著变化。电子健康记录在急性肾损伤中的作用应超越对急性肾损伤作为一种综合征的基于规则的检测。此类工具还有几种不同的潜在应用,包括急性肾损伤预测模型和临床决策支持系统,以提高急性肾损伤患者的护理质量和治疗结果。临床医生、管理人员和科学家对该领域的临床和研究兴趣都在不断增加。合理利用智能电子健康记录可以为临床医生提供及时、恰当和准确的信息,以提高为重症患者提供的护理质量,并协助研究人员获取新知识。在这篇综述文章中,我们讨论了电子健康记录在急性肾损伤领域的过去和现状。我们还分享了我们对这些设备未来潜力和发展方向的看法。