Redesigning electronic health record systems to support public health
Redesigning electronic health record systems to support public health
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DOI：
10.1016/j.jbi.2007.07.001
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发表时间：
2007-08-01
影响因子：
4.5
通讯作者：
Stephens, Kayann
中科院分区：
文献类型：
--
作者：
Kukafka, Rita;Ancker, Jessica S.;Stephens, Kayann
当前的电子健康记录系统主要侧重于临床，旨在提供患者级数据和提供者级决策支持。调整电子病历系统以满足公共卫生需求，为公共卫生实践和政策取得巨大进步提供了可能性。在本次审查中，我们评估了 EHR 功能，并将其映射到公共卫生的三个核心功能：评估、政策制定和保证。在此过程中，我们确定并讨论了当前系统的重要设计、实现和方法问题。例如，为了支持公共卫生对预防性健康和社会行为因素的传统关注，需要扩展电子病历数据模型以纳入环境、社会心理和其他非医疗数据元素，并且必须检查工作流程以确定收集这些数据的最佳方式。我们还认为，重新设计 EHR 系统以支持公共卫生不仅有利于公共卫生系统，也有利于消费者、医疗机构和个人提供者。 (C) 2007 年，爱思唯尔公司出版。
Current electronic health record systems are primarily clinical in focus, designed to provide patient-level data and provider-level decision support. Adapting EHR systems to serve public health needs provides the possibility of enormous advances for public health practice and policy. In this review, we evaluate EHR functionality and map it to the three core functions of public health: assessment, policy development, and assurance. In doing so, we identify and discuss important design, implementation, and methodological issues with current systems. For example, in order to support public health's traditional focus on preventive health and socio-behavioral factors, EHR data models would need to be expanded to incorporate environmental, psychosocial, and other non-medical data elements, and workflow would have to be examined to determine the optimal way of collecting these data. We also argue that redesigning EHR systems to support public health offers benefits not only to the public health system but also to consumers, health-care institutions, and individual providers. (C) 2007 Published by Elsevier Inc.