The use of Electronic Health Records to Support Population Health: A Systematic Review of the Literature.
The use of Electronic Health Records to Support Population Health: A Systematic Review of the Literature.
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DOI：
10.1007/s10916-018-1075-6
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发表时间：
2018-09-29
影响因子：
5.3
通讯作者：
Kaur H
中科院分区：
文献类型：
--
作者：
Kruse CS;Stein A;Thomas H;Kaur H
电子健康记录(EHR)作为一种“有意义的使用”出现在健康信息技术中，以提高医疗保健的质量和效率，以及人口健康方面的健康差距。在其他情况下，它们也表现出缺乏互操作性、功能性和许多医疗错误。有了适当的实施和培训，电子健康记录是管理人口健康的一个可行来源吗？这项系统审查的主要目标是通过查明和分析电子健康记录使用的促进者和障碍，评估电子健康记录对人口健康的使用之间的关系。作者检索CINAHL和MEDLINE(PubMed)，10/02/2012-10/02/2017，临床/学术核心期刊，MEDLINE全文，仅英文，人类物种，并对与我们的研究目标相关的文章进行评价。每篇文章都由多位评审员进行分析。小组成员认识到与环境卫生记录对人口健康的影响有关的共同促进者和障碍。工作组在三次协商一致会议后选出了最后的条款清单(n = 55)。在总共确定的26个因素中，63%(147/232)是促进者，37%(85/232)是障碍。约70%的促进者包括EHR的生产力/效率33次，提高质量和数据管理19次，监测17次，预防性护理15次。大约70%的障碍包括24次数据丢失，13次没有标准(互操作性)，12次生产力下降，10次技术过于复杂。分析发现，使用电子健康记录支持公共卫生的促进者多于障碍。更广泛地采用电子健康记录和更全面的互操作性标准，只会增强电子健康记录支持监测和疾病预防这一重要领域的能力。这项审查确定了使用电子健康记录支持公共卫生的促进者多于障碍，这意味着以这种方式使用电子健康记录具有一定的可用性和接受度。公共卫生行业应将他们的努力与互操作性项目结合起来，使电子健康记录得到充分采用和完全可互操作。这将极大地提高全国数据的可用性、准确性和全面性，从而增强标杆和疾病监测/预防能力。
Electronic health records (EHRs) have emerged among health information technology as “meaningful use” to improve the quality and efficiency of healthcare, and health disparities in population health. In other instances, they have also shown lack of interoperability, functionality and many medical errors. With proper implementation and training, are electronic health records a viable source in managing population health? The primary objective of this systematic review is to assess the relationship of electronic health records’ use on population health through the identification and analysis of facilitators and barriers to its adoption for this purpose. Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE (PubMed), 10/02/2012–10/02/2017, core clinical/academic journals, MEDLINE full text, English only, human species and evaluated the articles that were germane to our research objective. Each article was analyzed by multiple reviewers. Group members recognized common facilitators and barriers associated with EHRs effect on population health. A final list of articles was selected by the group after three consensus meetings (n = 55). Among a total of 26 factors identified, 63% (147/232) of those were facilitators and 37% (85/232) barriers. About 70% of the facilitators consisted of productivity/efficiency in EHRs occurring 33 times, increased quality and data management each occurring 19 times, surveillance occurring 17 times, and preventative care occurring 15 times. About 70% of the barriers consisted of missing data occurring 24 times, no standards (interoperability) occurring 13 times, productivity loss occurring 12 times, and technology too complex occurring 10 times. The analysis identified more facilitators than barriers to the use of the EHR to support public health. Wider adoption of the EHR and more comprehensive standards for interoperability will only enhance the ability for the EHR to support this important area of surveillance and disease prevention. This review identifies more facilitators than barriers to using the EHR to support public health, which implies a certain level of usability and acceptance to use the EHR in this manner. The public-health industry should combine their efforts with the interoperability projects to make the EHR both fully adopted and fully interoperable. This will greatly increase the availability, accuracy, and comprehensiveness of data across the country, which will enhance benchmarking and disease surveillance/prevention capabilities.
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DOI：
10.1136/amiajnl-2014-002726
发表时间：
2015-01
期刊：
Journal of the American Medical Informatics Association : JAMIA
影响因子：
--
作者：
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影响因子：
2.2
作者：
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通讯作者：
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影响因子：
105.7
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影响因子：
4.5
作者：
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DOI：
10.1136/amiajnl-2011-000219
发表时间：
2011-12-01
影响因子：
6.4
作者：
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通讯作者：
Shih, Sarah C.