电子病历提醒可提高 HIV 筛查率：Foch 医院试点 POP-up 项目。
Electronic medical record alert increases HIV screening rates: the Foch hospital pilot POP-up project.
机构信息
Department of Epidemiology - Data - Biostatistics, Delegation of Clinical Research and Innovation, Foch Hospital, Suresnes, France.
Department of Internal Medicine, Réseau Ville Hôpital Val de Seine, Foch Hospital, Suresnes, France.
出版信息
BMC Health Serv Res. 2022 Jun 16;22(1):784. doi: 10.1186/s12913-022-08176-y.
BACKGROUND
Despite significant national human immunodeficiency virus (HIV) screening activity, there are persistent delays in screening, and many missed diagnostic opportunities. To facilitate targeted screening, an electronic medical record (EMR) alert reminder was applied in the Foch hospital. Screening rates after implementation were reported.
METHODS
A prospective cohort analysis was performed in Foch Hospital between 24 April 2018 and 4 October 2019 among hospitalized patients born in high HIV prevalence countries and/or having social vulnerability criteria (universal health coverage). From the admissions software, when specific low health coverage was provided and/or high-prevalence country of birth was registered, an electronic alert (EMR alert) appeared on the ward where the patient was hospitalized. The EMR alert database was examined for HIV screening and activity responses from each service of the Hospital.
RESULTS
Eight thousand one hundred eighty-one alerts were recovered during the period for 1448 patients. 27 services used the EMR alert. Most of the alerts were directly closed (74.4%), 14.5% of the alerts were closed due to doctors declaring that they did not have time to respond. 297 (3.6%) of the 8181 alerts resulted in a prescription of HIV serology corresponding for 20.5% of the patients.
CONCLUSION
EMR alert can help to increase the rate of HIV screening in hospital care practice. Through this EMR alert system, HIV screening can be implemented as a common practice like any other medical alternative. Future research should examine the factors influencing physicians' attitudes to this alert system to improve the HIV screening rate.
背景
尽管国家开展了大量的人类免疫缺陷病毒（HIV）筛查活动，但仍存在筛查延迟和许多漏诊机会。为了促进有针对性的筛查，在 Foch 医院应用了电子病历（EMR）提醒。报告了实施后的筛查率。
方法
在 2018 年 4 月 24 日至 2019 年 10 月 4 日期间，在 Foch 医院对来自高 HIV 流行国家和/或具有社会脆弱性标准（全民健康覆盖）的住院患者进行了前瞻性队列分析。从入院软件中，当提供特定的低健康覆盖和/或高流行国家的出生时，会在患者住院的病房中出现电子警报（EMR 警报）。检查了 EMR 警报数据库，以了解医院各科室的 HIV 筛查和活动反应。
结果
在此期间，共收回了 8181 个警报，涉及 1448 名患者。27 个服务部门使用了 EMR 警报。大多数警报被直接关闭（74.4%），由于医生声明他们没有时间回应，14.5%的警报被关闭。在 8181 个警报中，有 297 个（3.6%）导致开具了 HIV 血清学处方，占患者的 20.5%。
结论
EMR 警报可以帮助提高医院护理实践中的 HIV 筛查率。通过这个 EMR 警报系统，可以将 HIV 筛查作为任何其他医疗替代方案一样实施常规做法。未来的研究应研究影响医生对该警报系统态度的因素，以提高 HIV 筛查率。
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