Gabriel Meghan Hufstader, Smith Jaime Y, Sow Max, Charles Dustin, Joseph Seth, Wilkins Tricia Lee
Assistant Professor, Department of Health Management and Informatics, University of Central Florida, 4364 Scorpius Drive, Orlando, FL 32816, USA.
Statistician, Surescripts 2800 Crystal Drive #1000, Arlington, VA 22202, USA
J Am Med Inform Assoc. 2016 May;23(3):562-9. doi: 10.1093/jamia/ocv151. Epub 2015 Nov 9.
To document national trends of electronic medication history use in the ambulatory setting and describe the characteristics and predicting factors of providers who regularly use medication history transaction capabilities through their e-prescribing systems.
The study used provider-initiated medication history data requests, electronically sent over an e-prescribing network from all 50 states and the District of Columbia. Data from 138,000 prescribers were evaluated using multivariate analyses from 2007 to 2013.
Medication history use showed significant growth, increasing from 8 to 850 million history requests during the study period. Prescribers on the network for <5 years had a lower likelihood of requests than those on the network for 5 or more years. Although descriptive analyses showed that prescribers in rural areas were alongside e-prescribing, and requesting medication histories more often than those in large and small cities, these findings were not significant in multivariate analyses. Providers in orthopedic surgery and internal medicine had a higher likelihood of more requests than family practice prescribers, with 12% and 7% higher likelihood, respectively.
Early adopters of e-prescribing have remained medication history users and have continually increased their volume of requests for medication histories.
Despite the fact that the use of medication histories through e-prescribing networks in the ambulatory care setting has not been encouraged through federal incentive programs, there has been substantial growth in the use of medication histories offered through e-prescribing networks.
记录门诊环境中电子用药史使用的全国趋势,并描述通过电子处方系统定期使用用药史交易功能的医疗服务提供者的特征和预测因素。
该研究使用了由医疗服务提供者发起的用药史数据请求,这些请求通过电子处方网络从美国所有50个州和哥伦比亚特区以电子方式发送。对2007年至2013年期间13.8万名开处方者的数据进行了多变量分析。
用药史的使用呈现出显著增长,在研究期间,用药史请求从800万次增加到8.5亿次。入网时间不足5年的开处方者提出请求的可能性低于入网5年或更长时间的开处方者。尽管描述性分析表明,农村地区的开处方者与电子处方同步,且比大城市和小城市的开处方者更频繁地请求用药史,但这些发现在多变量分析中并不显著。骨科手术和内科的医疗服务提供者比家庭医疗开处方者更有可能提出更多请求,可能性分别高出12%和7%。
电子处方的早期采用者一直是用药史的使用者,并且不断增加他们对用药史的请求量。
尽管联邦激励计划并未鼓励在门诊护理环境中通过电子处方网络使用用药史,但通过电子处方网络提供的用药史的使用仍有大幅增长。