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韩国电子健康记录的采用率:一项全国性调查。

Rate of electronic health record adoption in South Korea: A nation-wide survey.

作者信息

Kim Young-Gun, Jung Kyoungwon, Park Young-Taek, Shin Dahye, Cho Soo Yeon, Yoon Dukyong, Park Rae Woong

机构信息

Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.

Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, South Korea.

出版信息

Int J Med Inform. 2017 May;101:100-107. doi: 10.1016/j.ijmedinf.2017.02.009. Epub 2017 Feb 20.

Abstract

OBJECTIVE

The adoption rate of electronic health record (EHR) systems in South Korea has continuously increased. However, in contrast to the situation in the United States (US), where there has been a national effort to improve and standardize EHR interoperability, no consensus has been established in South Korea. The goal of this study was to determine the current status of EHR adoption in South Korean hospitals compared to that in the US.

METHODS

All general and tertiary teaching hospitals in South Korea were surveyed regarding their EHR status in 2015 with the same questionnaire as used previously. The survey form estimated the level of adoption of EHR systems according to 24 core functions in four categories (clinical documentation, result view, computerized provider order entry, and decision supports). The adoption level was classified into comprehensive and basic EHR systems according to their functionalities.

RESULTS

EHRs and computerized physician order entry systems were used in 58.1% and 86.0% of South Korean hospitals, respectively. Decision support systems and problem list documentation were the functions most frequently missing from comprehensive and basic EHR systems. The main barriers cited to adoption of EHR systems were the cost of purchasing (48%) and the ongoing cost of maintenance (11%).

DISCUSSION

The EHR adoption rate in Korean hospitals (37.2%) was higher than that in US hospitals in 2010 (15.1%), but this trend was reversed in 2015 (58.1% vs. 75.2%). The evidence suggests that these trends were influenced by the level of financial and political support provided to US hospitals after the HITECH Act was passed in 2009.

CONCLUSIONS

The EHR adoption rate in Korea has increased, albeit more slowly than in the US. It is logical to suggest that increased funding and support tied to the HITECH Act in the US partly explains the difference in the adoption rates of EHRs in both countries.

摘要

目的

韩国电子健康记录(EHR)系统的采用率持续上升。然而,与美国全国致力于改善和规范EHR互操作性的情况不同,韩国尚未达成共识。本研究的目的是确定韩国医院与美国医院相比EHR采用的现状。

方法

2015年,使用与之前相同的问卷对韩国所有综合医院和三级教学医院的EHR状况进行了调查。该调查问卷根据四类(临床文档、结果查看、计算机化医嘱录入和决策支持)中的24项核心功能评估了EHR系统的采用水平。根据其功能,采用水平分为综合EHR系统和基本EHR系统。

结果

韩国分别有58.1%和86.0%的医院使用了EHR和计算机化医嘱录入系统。决策支持系统和问题列表文档是综合和基本EHR系统中最常缺失的功能。采用EHR系统的主要障碍是购买成本(48%)和持续维护成本(11%)。

讨论

2010年韩国医院的EHR采用率(37.2%)高于美国医院(15.1%),但在2015年这一趋势发生了逆转(58.1%对75.2%)。有证据表明,这些趋势受到2009年《健康信息技术经济和临床健康法案》(HITECH Act)通过后美国医院获得的财政和政治支持水平的影响。

结论

韩国的EHR采用率有所提高,尽管比美国增长得更慢。可以合理推测,美国与《健康信息技术经济和临床健康法案》相关的资金和支持增加,部分解释了两国EHR采用率的差异。

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