Department of Radiology and Biomedical Imaging, University of California, San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
J Digit Imaging. 2018 Oct;31(5):611-614. doi: 10.1007/s10278-018-0077-8.
The purpose of this study was to objectively quantify the impact of implementing picture archiving and communication system-electronic medical record (PACS-EMR) integration on the time required to access data in the EMR and the frequency with which data are accessed by radiologists. Time to access a clinic note in the EMR was measured before and after integration with a stopwatch and compared by t test. An IRB-approved, HIPAA-compliant retrospective review of EMR access data from security audit logs was conducted for a 14-month period spanning the integration. Correlation of these data with report signatures identified the studies in which the radiologist accessed the EMR to obtain additional clinical data. Proportions of studies with EMR access were plotted and compared before and after integration using a chi-square test. Time to access the EMR decreased from 52 to 6 s (p < 0.001). Proportion of studies with EMR access increased from 36.7% (10,175/27,773) to 44.9% (10,843/24,153) after integration (p < 0.001). Integrating PACS and the EMR substantially decreases the time to access the EMR and is associated with a significant increase in the proportion of studies for which radiologists obtain additional clinical data.
这项研究的目的是客观地量化实施影像归档与通信系统-电子病历（PACS-EMR）集成对访问电子病历中数据所需时间以及放射科医生访问数据频率的影响。使用秒表在集成前后测量访问电子病历中临床记录的时间，并通过 t 检验进行比较。对集成期间 14 个月的安全审计日志中的电子病历访问数据进行了经过机构审查委员会批准且符合 HIPAA 规定的回顾性审查。将这些数据与报告签名相关联，以确定放射科医生访问电子病历以获取额外临床数据的研究。在集成前后使用卡方检验绘制并比较有电子病历访问的研究比例。访问电子病历的时间从 52 秒减少到 6 秒（p<0.001）。集成后，有电子病历访问的研究比例从 36.7%（10,175/27,773）增加到 44.9%（10,843/24,153）（p<0.001）。将 PACS 和电子病历集成可以大大减少访问电子病历的时间，并且与放射科医生获取额外临床数据的研究比例显著增加有关。
