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疫情前评估:美国医院在采用电子健康记录方面十年的进展

Pre-pandemic assessment: a decade of progress in electronic health record adoption among U.S. hospitals.

作者信息

Jiang John Xuefeng, Qi Kangkang, Bai Ge, Schulman Kevin

机构信息

Eli Broad College of Business, Michigan State University, East Lansing, MI 48824, United States.

Harbert College of Business, Auburn University,Auburn, AL 36949,United States.

出版信息

Health Aff Sch. 2023 Oct 21;1(5):qxad056. doi: 10.1093/haschl/qxad056. eCollection 2023 Nov.

Abstract

As the COVID-19 pandemic loomed, the adoption of electronic health records (EHRs) in US hospitals became a pivotal concern. This study provides a pre-pandemic assessment, highlighting a decade of progress in EHR adoption from 2009 to 2019, with the last available survey conducted from January to June of 2020. It delves into the current EHR adoption rates, variations across different hospital categories, the influence of major vendors, and the challenges in implementing these systems. The study found that basic EHR adoption surged from 6.6% to 81.2%, while comprehensive systems increased from 3.6% to 63.2%. Despite this growth, the findings point to enduring disparities among hospitals, a concentrated market share by 6 vendors (90%), and significant concerns regarding maintenance costs. These insights provide an invaluable snapshot of the state of EHR adoption at the brink of the pandemic, serving as a benchmark to assess hospitals' readiness to utilize digital infrastructure in health care. The conclusions underscore the necessity for strategic policy interventions to encourage a competitive landscape and guarantee equitable access, ultimately strengthening the health care system's responsiveness to global health crises such as COVID-19.

摘要

随着新冠疫情的逼近,美国医院采用电子健康记录(EHR)成为一个关键问题。本研究提供了疫情前的评估,突出了2009年至2019年这十年间在采用电子健康记录方面取得的进展,最后一次可用调查于2020年1月至6月进行。它深入探讨了当前电子健康记录的采用率、不同医院类别之间的差异、主要供应商的影响以及实施这些系统所面临的挑战。研究发现,基本电子健康记录的采用率从6.6%激增至81.2%,而综合系统则从3.6%增至63.2%。尽管有这种增长,但研究结果表明医院之间存在持续的差距,6家供应商占据了90%的集中市场份额,并且对维护成本存在重大担忧。这些见解提供了疫情爆发前夕电子健康记录采用情况的宝贵快照,作为评估医院利用医疗保健数字基础设施准备情况的基准。结论强调了战略政策干预的必要性,以鼓励竞争格局并确保公平获取,最终加强医疗保健系统对新冠疫情等全球健康危机的应对能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20aa/10986221/c348fe24076f/qxad056f1.jpg

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