Feasibility of extracting data from electronic medical records for research: an international comparative study.
Feasibility of extracting data from electronic medical records for research: an international comparative study.
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DOI：
10.1186/s12911-016-0332-1
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发表时间：
2016-07-13
影响因子：
3.5
通讯作者：
Car J
中科院分区：
文献类型：
--
作者：
van Velthoven MH;Mastellos N;Majeed A;O'Donoghue J;Car J
电子病历(EMR)为二次使用数据进行研究提供了巨大的潜力，可以提高医疗保健的安全性、质量和效率。它们还能够在人口一级衡量疾病负担。然而，这在不同国家可行的程度并不为人所知。这项研究的目的是：1)评估16个国家从电子病历中提取数据的信息治理程序；2)以2型糖尿病患者的管理为例，探索7个国家采用电子病历的程度以及电子病历数据的质量和一致性。我们包括从澳大利亚、亚洲、中东、欧洲到美洲的16个国家。我们采取了多种方法，包括在线文献回顾和对59名利益相关者的结构化访谈，其中包括25名医生、23名学者、7名EMR提供者和4名信息专员。考虑到最相关的问题，对数据进行了主题分析和综合。我们发现，信息治理的程序、采用水平和数据质量在所研究的国家之间存在差异。获得批准所需的时间和容易程度也差别很大。虽然有些国家似乎已准备好对电子病历数据进行二次利用，但在其他国家发现了几个障碍，包括使用电子病历数据进行研究的经验有限、缺乏标准政策和程序、官僚作风、机密性、数据安全问题、技术问题和成本。这是第一项国际比较研究，阐明了在多个国家提取电子病历数据的可行性。这项研究将为今后的讨论和政策制定提供信息，这些政策旨在加快在高收入和中等收入国家采用电子病历系统，并抓住因使用电子病历解决方案而产生的数据二次利用的巨大潜力。本文的在线版本(doi：10.1186/s12911-0160332-1)包含补充材料，授权用户可以使用。
Electronic medical records (EMR) offer a major potential for secondary use of data for research which can improve the safety, quality and efficiency of healthcare. They also enable the measurement of disease burden at the population level. However, the extent to which this is feasible in different countries is not well known. This study aimed to: 1) assess information governance procedures for extracting data from EMR in 16 countries; and 2) explore the extent of EMR adoption and the quality and consistency of EMR data in 7 countries, using management of diabetes type 2 patients as an exemplar. We included 16 countries from Australia, Asia, the Middle East, and Europe to the Americas. We undertook a multi-method approach including both an online literature review and structured interviews with 59 stakeholders, including 25 physicians, 23 academics, 7 EMR providers, and 4 information commissioners. Data were analysed and synthesised thematically considering the most relevant issues. We found that procedures for information governance, levels of adoption and data quality varied across the countries studied. The required time and ease of obtaining approval also varies widely. While some countries seem ready for secondary uses of data from EMR, in other countries several barriers were found, including limited experience with using EMR data for research, lack of standard policies and procedures, bureaucracy, confidentiality, data security concerns, technical issues and costs. This is the first international comparative study to shed light on the feasibility of extracting EMR data across a number of countries. The study will inform future discussions and development of policies that aim to accelerate the adoption of EMR systems in high and middle income countries and seize the rich potential for secondary use of data arising from the use of EMR solutions. The online version of this article (doi:10.1186/s12911-016-0332-1) contains supplementary material, which is available to authorized users.