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基于电子医嘱的计算机医嘱录入系统是否会在急诊科导致意料之外的后果(昂贵且不必要的检查)?

Can CPOE Based on Electronic Order Sets Cause Unintended Consequences (Expensive and Unnecessary Tests) at the Emergency Department?

机构信息

Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.

Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

出版信息

Stud Health Technol Inform. 2022 Jun 6;290:192-196. doi: 10.3233/SHTI220059.

Abstract

Computerized Provider Order Entry (CPOE) systems may cause unintended consequences. This study aimed to describe the on-going system for CPOE order sets, and to explore an economic evaluation at the Emergency Department. First, we developed a costs dashboard which showed us the significant and excessive use of medical tests per consultation. We identified the top 10 most widely used and most expensive tests. Additionally we noticed that the labs seemed to continually increase. Then, we found that 27% of the consultations have at least one item of laboratory practice between January and February 2020, and this represents more than 80% of the consultation costs. Health care spending has reached epic proportions globally. We think that it is time to rethink effective strategies. Maybe it is time to deactivate/remove electronic order sets (EOSs) and the functionality to develop and create their own "private" order sets, in order to eliminate waste and inefficiencies.

摘要

计算机化医嘱录入 (CPOE) 系统可能会带来意想不到的后果。本研究旨在描述急诊部 CPOE 医嘱集的现行系统,并探讨其经济评估。首先,我们开发了一个成本仪表板,该仪表板显示了每次咨询中大量且过度使用的医疗检查。我们确定了使用最广泛和最昂贵的前 10 项检查。此外,我们注意到实验室的检查似乎在不断增加。然后,我们发现 2020 年 1 月至 2 月期间,27%的咨询至少有一项实验室检查项目,这占咨询费用的 80%以上。全球医疗保健支出已达到空前的规模。我们认为现在是时候重新思考有效的策略了。也许是时候停用/删除电子医嘱集 (EOS) 和开发创建自己的“私人”医嘱集的功能了,以消除浪费和低效率。

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