Plantier Morgane, Havet Nathalie, Durand Thierry, Caquot Nicolas, Amaz Camille, Biron Pierre, Philip Irène, Perrier Lionel
Direction de la Recherche Clinique et de l'Innovation, Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France.
University of Lyon, Université Claude Bernard Lyon 1, ISFA, Laboratoire SAF, 50 avenue Tony Garnier, 69007 Lyon, France.
Int J Med Inform. 2017 Jun;102:156-165. doi: 10.1016/j.ijmedinf.2017.04.002. Epub 2017 Apr 4.
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 the 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 quality of care management in acute care hospitals throughout France.
This retrospective study was based on data derived from three national databases for the year 2011: IPAQSS (indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. Several multivariate models were used to examine the association between the use of EHRs and specific EHR features with four quality indicators: the quality of patient record, the delay in sending information at hospital discharge, the pain status evaluation, and the nutritional status evaluation, while also adjusting for hospital characteristics.
The models revealed a significant positive impact of EHR use on the four quality indicators. Additionally, they showed a differential impact according to the functionality of the element of the health record that was computerized. All four quality indicators were also impacted by the type of hospital, the geographical region, and the severity of the pathology.
These results suggest that, to improve the quality of care management in hospitals, EHR adoption represents an important lever. They complete previous work dealing with EHR and the organizational performance of hospital surgical units.
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，其中包括推广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。
本研究旨在评估在法国各地急症医院使用电子健康记录对护理管理质量的影响。
这项回顾性研究基于2011年来自三个国家数据库的数据：IPAQSS（医疗保健质量与管理改进指标，“IPAQSS”）、Hospi - Diag（法国医院绩效指标）以及国家认证数据库。使用了几个多变量模型来检验电子健康记录的使用以及电子健康记录的特定特征与四个质量指标之间的关联：患者记录质量、出院时信息发送延迟、疼痛状态评估以及营养状态评估，同时还对医院特征进行了调整。
模型显示使用电子健康记录对这四个质量指标有显著的积极影响。此外，根据健康记录中被计算机化元素的功能，显示出了不同的影响。所有四个质量指标还受到医院类型、地理区域以及病理严重程度的影响。
这些结果表明，为提高医院护理管理质量，采用电子健康记录是一个重要手段。它们完善了先前关于电子健康记录与医院外科部门组织绩效的研究工作。
