Robichaux Catherine, Tietze Mari, Stokes Felicia, McBride Susan
University of Mary, Bismarck, North Dakota and UT Health, San Antonio, Texas (Dr Robichaux); Texas Woman's University, Dallas (Dr Tietze); American Nurses Association, Silver Spring, Maryland (Dr Stokes); and Health Sciences Center, Texas Tech University, Lubbock (Dr McBride).
ANS Adv Nurs Sci. 2019 Jul/Sep;42(3):193-205. doi: 10.1097/ANS.0000000000000282.
Since the 2009 publication by Petrovskaya et al on, "Dilemmas, Tetralemmas, Reimagining the Electronic Health Record," and passage of the Health Information Technology for Economic Clinical Health (HITECH) Act, 96% of hospitals and 78% of providers have implemented the electronic health record. While many positive outcomes such as guidelines-based clinical decision support and patient portals have been realized, we explore recent issues in addition to those continuing problems identified by Petrovskaya et al that threaten patient safety and integrity of the profession. To address these challenges, we integrate polarity thinking with the tetralemma model discussed by Petrovskaya et al and propose application of a virtue ethics framework focused on cultivation of technomoral wisdom.
自2009年彼得罗夫斯卡娅等人发表《困境、四难推理、重新构想电子健康记录》以及《经济临床健康卫生信息技术（HITECH）法案》通过以来，96%的医院和78%的医疗服务提供者已经实施了电子健康记录。虽然已经实现了许多积极成果，如基于指南的临床决策支持和患者门户网站，但我们除了探讨彼得罗夫斯卡娅等人所指出的持续存在的问题之外，还研究近期出现的、威胁患者安全和行业诚信的问题。为应对这些挑战，我们将极性思维与彼得罗夫斯卡娅等人讨论的四难推理模型相结合，并提出应用一个侧重于培养技术道德智慧的美德伦理框架。
