采用电子健康记录能否提升医院外科科室的组织绩效？来自法国电子手术信息系统（PREPS-SIPS）研究的结果。

Does adoption of electronic health records improve organizational performances of hospital surgical units? Results from the French e-SI (PREPS-SIPS) study.

作者信息

Plantier Morgane, Havet Nathalie, Durand Thierry, Caquot Nicolas, Amaz Camille, Philip Irène, Biron Pierre, Perrier Lionel

机构信息

Direction de la Recherche Clinique et de l'Innovation, Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France.

GATE-LSE UMR-CNRS 5824, 93 Chemin des Mouilles, 69130 Ecully, France.

出版信息

Int J Med Inform. 2017 Feb;98:47-55. doi: 10.1016/j.ijmedinf.2016.12.002. Epub 2016 Dec 5.

DOI:10.1016/j.ijmedinf.2016.12.002

PMID:28034412

Abstract

BACKGROUND

Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the organizational performances of acute care hospital surgical units throughout France.

METHODS

This retrospective study was based on data derived from three national databases for year the 2012: IPAQSS (Indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. National data and methodological support were provided by the French Ministry of Health (DGOS) and the French National Authority for Health (HAS). Multivariate linear models were used to assess four organizational performance indicators: the occupancy rate of surgical inpatient beds, operating room utilization, the activity per surgeon, and the activity per both nurse anesthetist and anesthesiologist which were dependent variables. Several independent variables were taken into account, including the degree of EHR use.

RESULTS

The models revealed a significant positive impact of EHR use on operating room utilization and bed occupancy rates for surgical inpatient units. No significant association was found between the activity per surgeon or the activity per nurse anesthetist and anesthesiologist with EHR use. All four organizational performance indicators were impacted by the type of hospital, the geographical region, and the severity of the pathologies.

CONCLUSION

We were able to verify the purported potential benefits of EHR use on the organizational performances of surgical units in French hospitals.

摘要

背景

电子健康记录（EHR）在全球医疗系统中越来越多地被采用。在法国，“2012 - 2017数字医院”计划作为健康信息技术（HIT）现代化战略计划的一部分得以实施，其中包括推动广泛使用电子健康记录。鉴于前期有大量投资成本以及持续的运营费用，从其能否改善医院绩效的角度评估该系统很重要。本研究的目的是评估电子健康记录的使用对法国各地急症护理医院外科病房组织绩效的影响。

方法

这项回顾性研究基于2012年来自三个国家数据库的数据：IPAQSS（医疗保健质量和管理改进指标，“IPAQSS”）、Hospi - Diag（法国医院绩效指标）以及国家认证数据库。国家数据和方法支持由法国卫生部（DGOS）和法国国家卫生管理局（HAS）提供。使用多元线性模型评估四个组织绩效指标：外科住院病床占用率、手术室利用率、每位外科医生的工作量以及每位麻醉护士和麻醉医生的工作量，这些是因变量。考虑了几个自变量，包括电子健康记录的使用程度。