e-Health Research and Patient-Centered Care Examining Theory, Methods, and Application
e-Health Research and Patient-Centered Care Examining Theory, Methods, and Application
复制标题
DOI：
10.1016/j.amepre.2009.10.027
复制
发表时间：
2010-01-01
影响因子：
5.5
通讯作者：
Croyle, Robert T.
中科院分区：
文献类型：
--
作者：
Atienza, Audie A.;Hesse, Bradford W.;Croyle, Robert T.
美国和欧洲的人口调查表明，越来越多的人正在寻求互联网等技术来获取健康信息。 1-3 尽管如此，公众仍然依赖并信任卫生专业人员提供和解释健康信息，3, 4 个人正在将通过技术渠道获得的信息带给卫生专业人员，以提出更精致和具体的问题。 3, 5 因此，与医疗保健提供者的沟通和互动对于患者来说仍然很重要，可以帮助患者破译和解释他们越来越多地通过技术获得的信息。在医疗保健提供者方面，健康信息技术的采用速度较慢，但其使用量正在增长。美国医疗机构全面电子健康记录（EHR）的采用率相当低（5%）。 6 然而，许多医院确实存在部分 EHR 系统，6 并且已经开发了几种模型 EHR（例如，Kaiser Permanente、7 退伍军人健康管理局、8 和 Intermountain Healthcare 9 的 EHR 模型）。对综合电子病历的初步评估表明，这些技术可以有效监测慢性病患者，具有成本效益，并且可以为患者和提供者所接受。 10, 11 公众和医疗保健专业人员对信息技术的采用和使用的增加（尽管医疗保健机构的速度较慢）改变了医疗保健的格局，患者越来越成为健康信息的积极消费者。 12, 13 此外，医学研究所 (IOM) 14 建议的以患者为中心的医疗保健目标可能会通过电子医疗应用的战略性使用而得到促进。 15 一些人认为，将行为电子健康干预措施与健康信息技术系统（即电子健康记录）相结合可能会提高患者的依从性、需求和此类干预措施的成本效益。 16, 17 然而，迄今为止，相对较少的研究人员开始进行这种综合性且往往是跨学科的努力，为患者群体开发和严格评估行为电子健康项目。因此，我们目前正处于行为信息学和患者护理研究整合的黎明。将合理的研究方法纳入针对患者人群的电子健康计划对于评估这些计划的功效和效果仍然至关重要。 18, 19 然而，电子医疗计划在患者中的完善和传播不仅需要评估这些计划是否有效，还需要评估这些计划如何以及为何发挥作用。因此，需要结合理论和概念模型来指导研究人员。此外，采用健康信息技术需要考虑与将技术和研究设计整合到临床环境相关的实际问题（例如，临床工作流程）。因此，本期论文涉及与以患者为中心的护理研究相关的三个主要电子医疗主题领域：（1）理论在电子医疗研究中的运用；（2）利用技术改进研究设计和方法； (3)电子医疗研究在临床环境中的应用。
Population-based surveys in the US and Europe have indicated that a growing majority of individuals are looking to technologies, such as the Internet, for health information. 1–3 Still, the public continues to rely on and trust health professionals to provide and interpret health information, 3, 4 and individuals are bringing the information acquired through technologic channels to health professionals to ask more refined and specific questions. 3, 5 Thus, communications and interactions with healthcare providers remain important for patients to help decipher and interpret the information they are increasingly obtaining via technology. On the healthcare provider end, the adoption of health information technology has been slower, but it is growing in use. The level of adoption of comprehensive electronic health records (EHRs) has been rather low (5%) among US medical institutions. 6 However, partial EHR systems do exist in many hospitals, 6 and several model EHRs have been developed (eg, those at Kaiser Permanente, 7 Veterans Health Administration, 8 and Intermountain Healthcare 9). Preliminary evaluations of comprehensive EHRs have noted that these technologies can effectively monitor chronic disease patients, be cost effective, and be acceptable to both patients and providers. 10, 11 The increases in the adoption and use of information technologies by both the public and healthcare professionals (albeit slower among healthcare institutions) has changed the landscape of health care in which patients are increasingly becoming active consumers of health information. 12, 13 Moreover, the aim of making health care patient-centered, as recommended by the Institute ofMedicine (IOM) 14 may likely be facilitated with the strategic use of e-health applications. 15 Some have argued that integrating behavioral e-health interventions with health information technology systems (ie, electronic health records) may increase patient compliance, demand, and the cost effectiveness of such interventions. 16, 17 Yet, to date, relatively few researchers have embarked on this integrative and often interdisciplinary endeavor of developing and rigorously evaluating behavioral e-health programs for patient populations. Thus, we are currently at the dawn of the integration of behavioral informatics and patient care research. Integrating sound research methods into e-health programs aimed at patient populations remains essential for evaluating the efficacy and effectiveness of these programs. 18, 19 Yet, the refinement and dissemination of e-health programs among patients require an assessment of not only whether the programs are effective, but also how and why these programs work. Thus, the incorporation of theory and conceptual models are required to guide researchers. Further, adoption of health information technology requires the consideration of practical issues (eg, clinic work flow) related to integrating technology and research designs into the clinical setting. Therefore, the papers in this theme issue address three major e-health topic areas relevant to patient-centered care research:(1) the use of theory in e-health research;(2) the advancement of research designs and methods with the use of technology; and (3) the application of e-health research in a clinical setting.