Stair T O
Department of Surgery, University of Maryland at Baltimore, 21224, USA.
J Emerg Med. 1998 Nov-Dec;16(6):895-7. doi: 10.1016/s0736-4679(98)00106-1.
From a convenience sample of 500 consecutive patients seen in the emergency department (ED), occasions were recorded when data from the Veterans Affairs Decentralized Hospital Computer Program provided immediate clinical decision support and obviated redundant laboratory tests. Patient care was improved by access to inpatient discharge summaries in 85 cases (19%), laboratory results in 34 (7%), pharmacy records of allergies and prescriptions in 30 (6%), radiologic reports in 19 (4%), and electrocardiograms in 11 (2%). Overall savings in tests, prescriptions, admissions, and errors were estimated at about $5 per visit. Availability of previous laboratory results clearly decreased ordering of redundant studies. Computer-based medical records also provided details of previous diagnoses, treatments, allergies, and current medications. On many occasions, the presumptive diagnosis had already been worked up and proven or disproven, thus simplifying the entire encounter.
从急诊科连续就诊的500名患者的便利样本中，记录了退伍军人事务部分散式医院计算机程序的数据提供即时临床决策支持并避免重复实验室检查的情况。85例（19%）患者通过获取住院出院小结改善了医疗护理，34例（7%）通过获取实验室结果，30例（6%）通过获取药房过敏和处方记录，19例（4%）通过获取放射学报告，11例（2%）通过获取心电图。每次就诊估计在检查、处方、住院和差错方面总体节省约5美元。既往实验室结果的可获取性明显减少了重复检查的医嘱。基于计算机的病历还提供了既往诊断、治疗、过敏和当前用药的详细信息。在很多情况下，初步诊断已经完成并得到证实或排除，从而简化了整个诊疗过程。
