WHAT CAN INFORMATION-SYSTEMS DO FOR PRIMARY HEALTH-CARE - AN INTERNATIONAL PERSPECTIVE
WHAT CAN INFORMATION-SYSTEMS DO FOR PRIMARY HEALTH-CARE - AN INTERNATIONAL PERSPECTIVE
复制标题
DOI：
10.1016/0277-9536(92)90281-t
复制
发表时间：
1992-05-01
影响因子：
5.4
通讯作者：
CIBULSKIS, R
中科院分区：
文献类型：
--
作者：
SANDIFORD, P;ANNETT, H;CIBULSKIS, R
卫生管理人员、公共卫生专家和技术官僚已将卫生信息系统的改革列为优先事项。虽然每一个群体都承诺从信息系统的改进中获得重大利益，但没有充分注意到信息技术的理论可能性由于卫生系统的特点而受到的限制，而信息系统只是卫生系统的一部分。管理人员期望提高效率和合理分配资源，但合理的决策并不自动伴随着信息的改善。流行病学家和公共卫生专家寻求更有效和更公平的保健系统，但方法问题和许多传统流行病学方法的费用继续限制疾病监测、方案监测和评价的效用。管理人员和流行病学家都面临着在集中式卫生系统内寻求建立本地敏感信息系统时出现的冲突。技术官僚认为微型计算机是信息系统真正有效的必要条件，也是将卫生工作者从填表的繁重工作中解放出来的一种手段。然而，卫生系统的组织演变速度没有跟上信息技术的快速发展。有相当大的健康别针是从卫生信息系统的改革，但要实现这些是必要的，这一进程是“行动主导”，而不是传统的，“数据主导”的良好前景。后一种方法将数据本身视为目的;相反，“行动主导”方法将信息视为干预措施的需要，重点是信息将如何影响决策。为了改善信息以改善健康状况，必须采取战略，确保信息经常为决策提供信息，并被视为达到改善健康目的的一种手段。
The reform of health information systems has been made a priority by health managers, public health specialists and technocrats. While each of these groups has promised major benefits from improvements in information systems, insufficient attention has been paid to the limitations placed upon the theoretical possibilities of information technology by the characteristics of the health system of which the information system is but a part. Managers anticipate improved efficiency and rational allocation of resources, but rational decision making does not automatically follow from improvements in information. Epidemiologists and public health specialists seek more effective and equitable health systems but methodological problems and the expense of many conventional epidemiological approaches continue to limit the usefulness of disease surveillence, programme monitoring and evaluation. Both managers and epidemiologists are confronted with the conflicts which arise in seeking to create locally sensitive information systems within centralised health systems. Technocrats see microcomputers as essential for information systems to be truly effective and as a means of liberating health workers from the drudgery of form filling. However, the rate of organisational evolution in the health system has not kept pace with the rapid development of information technology. There are good prospects for considerable health pin to be wrought from reforms in health information systems but to realise these it is necessary that this process be 'action-led' rather than, as is conventional, 'data-led'. The latter approach sees data as the end in itself; the 'action-led' approach, in contrast, regards information as needs to interventions with a focus on how information will influence decisions. For improvements in information to result in improved health, strategies must be adopted which will ensure that information routinely informs decisions and is seen as a means to the end of improving health.