电子病历助力促肾上腺皮质激素刺激试验性能提升。
Enhanced cosyntropin stimulation test performance enabled by electronic medical record.
作者信息
Ben-Shlomo Anat, Guzman Joseph, Mirocha James
机构信息
Pituitary Center, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Davis Building, Room 3021, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
Biostatistics Core, Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
出版信息
Pituitary. 2016 Oct;19(5):503-6. doi: 10.1007/s11102-016-0731-4.
PURPOSE
To improve performance of the cosyntropin stimulation test (CST) used for diagnosis of adrenal-cortisol insufficiency by implementing an electronic medical record (EMR) system protocol.
METHODS
We implemented a SmartForm protocol of the validated CST in our EMR system (CS-Link™, EPIC) system and compared medical staff test performance before and after protocol implementation.
RESULTS
Correct performance of the CST improved significantly after EMR implementation. The number of correctly performed CSTs increased from 16.1 % before to 53.5 % after implementation (p < 0.0001) while those performed incorrectly and were uninterpretable decreased from 36.2 to 7.1 % (p < 0.0001). This performance improvement result in a calculated cost savings of $50,414 for every 100 tests performed.
CONCLUSIONS
The EMR system is useful for guiding medical staff to accurately perform the CST, reduce the number of wasted tests, and maximize staff time and resources.
目的
通过实施电子病历（EMR）系统协议，提高用于诊断肾上腺皮质功能不全的促肾上腺皮质激素刺激试验（CST）的性能。
方法
我们在电子病历系统（CS-Link™，EPIC）中实施了经过验证的CST智能表单协议，并比较了协议实施前后医务人员的测试性能。
结果
实施电子病历后，CST的正确执行情况有显著改善。正确执行的CST数量从之前的16.1%增加到实施后的53.5%（p<0.0001），而执行错误和无法解读的比例从36.2%降至7.1%（p<0.0001）。这种性能提升使得每进行100次测试可节省50414美元的计算成本。
结论
电子病历系统有助于指导医务人员准确执行CST，减少浪费的测试数量，并最大限度地利用员工时间和资源。
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