Jiang Tao, Yu Ping, Hailey David, Ma Jun, Yang Jie
Centre for IT-enabled Transformation, School of Computing and Information Technology, University of Wollongong, Wollongong, NSW, 2522, Australia.
SMART Infrastructure Facility, University of Wollongong, Wollongong, NSW, 2522, Australia.
J Med Syst. 2016 Sep;40(9):204. doi: 10.1007/s10916-016-0553-y. Epub 2016 Aug 8.
To obtain indications of the influence of electronic health records (EHR) in managing risks and meeting information system accreditation standard in Australian residential aged care (RAC) homes. The hypothesis to be tested is that the RAC homes using EHR have better performance in meeting information system standards in aged care accreditation than their counterparts only using paper records for information management. Content analysis of aged care accreditation reports from the Aged Care Standards and Accreditation Agency produced between April 2011 and December 2013. Items identified included types of information systems, compliance with accreditation standards, and indicators of failure to meet an expected outcome for information systems. The Chi-square test was used to identify difference between the RAC homes that used EHR systems and those that used paper records in not meeting aged care accreditation standards. 1,031 (37.4%) of 2,754 RAC homes had adopted EHR systems. Although the proportion of homes that met all accreditation standards was significantly higher for those with EHR than for homes with paper records, only 13 RAC homes did not meet one or more expected outcomes. 12 used paper records and nine of these failed the expected outcome for information systems. The overall contribution of EHR to meeting aged care accreditation standard in Australia was very small. Risk indicators for not meeting information system standard were no access to accurate and appropriate information, failure in monitoring mechanisms, not reporting clinical incidents, insufficient recording of residents' clinical changes, not providing accurate care plans, and communication processes failure. The study has provided indications that use of EHR provides small, yet significant advantages for RAC homes in Australia in managing risks for information management and in meeting accreditation requirements. The implication of the study for introducing technology innovation in RAC in Australia is discussed.
为了解电子健康记录(EHR)对澳大利亚老年护理院(RAC)管理风险及满足信息系统认证标准的影响。待检验的假设是,使用EHR的RAC院落在老年护理认证中满足信息系统标准方面比仅使用纸质记录进行信息管理的同行表现更好。对2011年4月至2013年12月期间老年护理标准与认证局发布的老年护理认证报告进行内容分析。确定的项目包括信息系统类型、符合认证标准情况以及未达到信息系统预期结果的指标。采用卡方检验来确定使用EHR系统的RAC院与使用纸质记录的院落在未达到老年护理认证标准方面的差异。2754家RAC院中,1031家(37.4%)采用了EHR系统。尽管使用EHR的院落在满足所有认证标准方面的比例显著高于使用纸质记录的院落,但只有13家RAC院未达到一项或多项预期结果。其中12家使用纸质记录,其中9家未达到信息系统的预期结果。在澳大利亚,EHR对满足老年护理认证标准的总体贡献非常小。未达到信息系统标准的风险指标包括无法获取准确和适当的信息、监测机制失效、未报告临床事件、居民临床变化记录不足、未提供准确的护理计划以及沟通流程失败。该研究表明,使用EHR为澳大利亚的RAC院落在信息管理风险及满足认证要求方面提供了虽小但显著的优势。讨论了该研究对澳大利亚RAC引入技术创新的启示。