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国家卫生模式与基层医疗中电子健康和电子处方的采用——来自欧洲的新证据。

National Health Models and the Adoption of E-Health and E-Prescribing in Primary Care - New Evidence from Europe.

作者信息

Brennan James, McElligott Annette, Power Norah

机构信息

University of Limerick.

出版信息

J Innov Health Inform. 2015 Nov 25;22(4):399-408. doi: 10.14236/jhi.v22i4.97.

Abstract

OBJECTIVE

Recent research from the European Commission (EC) suggests that the development and adoption of eHealth in primary care is significantly influenced by the context of the national health model in operation. This research identified three national health models in Europe at this time - the National Health Service (NHS) model, the social insurance system (SIS) model and the transition country (TC) model, and found a strong correlation between the NHS model and high adoption rates for eHealth. The objective of this study is to establish if there is a similar correlation in one specific application area - electronic prescribing (ePrescribing) in primary care.

METHODS

A review of published literature from 2000 to 2014 was undertaken covering the relevant official publications of the European Union and national government as well as the academic literature. An analysis of the development and adoption of ePrescribing in Europe was extracted from these data.

RESULTS

The adoption of ePrescribing in primary care has increased significantly in recent years and is now practised by approximately 32% of European general practitioners. National ePrescribing services are now firmly established in 11 countries, with pilot projects underway in most others. The highest adoption rates are in countries with the NHS model, concentrated in the Nordic area. The electronic transmission of prescriptions continues to pose a significant challenge, especially in SIS countries and TCs.

CONCLUSIONS

There is a strong correlation between the NHS model and high adoption rates for ePrescribing similar to the EC findings on the adoption of eHealth. It may be some time before many SIS countries and TCs reach the same adoption levels for ePrescribing and eHealth in primary care as most NHS countries.

摘要

目的

欧盟委员会(EC)近期的研究表明,初级保健中电子健康的发展与采用受到现行国家卫生模式背景的显著影响。该研究确定了目前欧洲的三种国家卫生模式——国民健康服务(NHS)模式、社会保险系统(SIS)模式和转型国家(TC)模式,并发现NHS模式与电子健康的高采用率之间存在很强的相关性。本研究的目的是确定在一个特定应用领域——初级保健中的电子处方(ePrescribing)是否存在类似的相关性。

方法

对2000年至2014年发表的文献进行了综述,涵盖欧盟和国家政府的相关官方出版物以及学术文献。从这些数据中提取了欧洲电子处方发展与采用情况的分析。

结果

近年来,初级保健中电子处方的采用率显著提高,目前约32%的欧洲全科医生在使用。国家电子处方服务目前已在11个国家稳固确立,大多数其他国家也在开展试点项目。采用率最高的是采用NHS模式的国家,集中在北欧地区。处方的电子传输仍然构成重大挑战,尤其是在SIS国家和转型国家。

结论

NHS模式与电子处方的高采用率之间存在很强的相关性,类似于欧盟委员会关于电子健康采用情况的研究结果。许多SIS国家和转型国家在初级保健中达到与大多数NHS国家相同的电子处方和电子健康采用水平可能还需要一段时间。

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