Rappaport S H
VHA Medical Center-UCLA San Fernando Valley Program, Sepulveda, USA.
Proc AMIA Annu Fall Symp. 1996:648-52.
To facilitate the communication of ideas, orders and treatment plans among providers practicing in a multidisciplinary ambulatory care setting, we have created an event-directed messaging system integrated into our larger Ambulatory Care Information System (ACIS). ACIS has been operational since 1992 and currently supports an average of 350 patient visits per day. The new messaging system permits a provider to send a message to the next provider who will be caring for a patient. The messages can be sent to any provider offering care in the future, or they can be directed to future visits with a particular clinical service. In contrast to traditional electronic mail systems, messages are not directed to specific providers or groups of provider. Messages are instead directed to a specific clinical event, namely a patient's visit to an appropriate clinic. Messages are displayed when a patient returns for a designated visit, both as part of a pre-printed progress note upon which a provider documents the visit and as part of a hypertext-based general information display in an electronic medical record. The messaging system helps providers ensure that subsequent providers caring for their patients will be alerted to pertinent aspects of a patient's care. It also similarly helps providers quickly gain familiarity with those issues prior providers had felt were important to highlight or did not want to risk being overlooked.
为促进在多学科门诊护理环境中执业的医疗服务提供者之间交流想法、医嘱和治疗计划，我们创建了一个事件导向的消息系统，该系统集成到了我们更大的门诊护理信息系统（ACIS）中。ACIS自1992年起投入使用，目前平均每天支持350例患者就诊。新的消息系统允许医疗服务提供者向接下来将护理某患者的下一位医疗服务提供者发送消息。这些消息可以发送给未来任何提供护理服务的医疗服务提供者，或者也可以针对特定临床服务的未来就诊发送。与传统电子邮件系统不同，消息不是发送给特定的医疗服务提供者或医疗服务提供者群体。相反，消息是针对特定的临床事件，即患者前往合适诊所就诊。当患者返回进行指定就诊时，消息会显示出来，既作为医疗服务提供者记录就诊情况的预印病程记录的一部分，也作为电子病历中基于超文本的一般信息显示的一部分。该消息系统有助于医疗服务提供者确保后续护理其患者的医疗服务提供者会收到有关患者护理相关方面的提醒。它同样有助于医疗服务提供者快速熟悉之前的医疗服务提供者认为重要而需突出强调或不想冒险被忽视的那些问题。
