Department of Internal Medicine, University of Toronto, Toronto, ON, Canada.
Division of Gastroenterology, University of Toronto, Toronto, ON, Canada.
Can J Gastroenterol Hepatol. 2016;2016:9423142. doi: 10.1155/2016/9423142. Epub 2016 Apr 26.
Colonoscopy reports are important communication tools for providers and patients with potential to serve as information sources for research, quality, performance, and resource management. Despite decades of work, studies continue to indicate that colonoscopy reports are often incomplete. Although electronic medical records (EMRs) and databases can address this problem, costs, workflow, and interoperability (difficulty exchanging information between systems) continue to limit adoption and implementation of endoscopy EMRs in Canada and elsewhere. Quality and reporting guidelines alone have proven to be insufficient. In this review we have derived and applied five key themes to challenges in the current state of colonoscopy reporting and propose strategies to address them.
结肠镜检查报告是医生和患者之间进行有效沟通的重要工具，它也有可能成为研究、质量、绩效和资源管理的信息来源。尽管已经进行了几十年的研究，但研究仍表明，结肠镜检查报告往往不够完整。尽管电子病历（EMR）和数据库可以解决这个问题，但成本、工作流程和互操作性（在系统之间交换信息的难度）继续限制了加拿大和其他地方内窥镜 EMR 的采用和实施。仅靠质量和报告指南已被证明是不够的。在本综述中，我们针对当前结肠镜检查报告的挑战，推导出并应用了五个关键主题，并提出了应对这些挑战的策略。
