Is the Electronic Health Record the Answer to Improving Patient Compliance with Recommended Health Interventions?
Is the Electronic Health Record the Answer to Improving Patient Compliance with Recommended Health Interventions?
复制标题
电子健康记录是提高患者对推荐健康干预措施依从性的答案吗？
DOI：
10.1089/jwh.2017.6896
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Teoh,Deanna
中科院分区：
文献类型：
--
作者：
Teoh,Deanna
The mortality rate from cervical cancer has decreased 70% since the implementation of routine screening with Papanicolaou (Pap) tests in the United States in the 1950s. 1, 2 This has been achieved through the identification and treatment of precursor lesions before the development of cancer and the identification of early stage cancer when it is still curable. Over the past few decades, we have seen the development of more sensitive tests, first with liquid-based cytology, and more recently with testing for the causative agent of cervical cancer, human papillomavirus (HPV).Despite these screening efforts, we have not been able to eradicate the disease. This is due to the large number of women who remain unscreened, or who do not get the proper diagnostic evaluation, treatment, or follow-up when a cervical cancer precursor is diagnosed. Given the ability of optimal screening and treatment to prevent cervical cancer, it is not surprising that cervical cancer disproportionately affects women with limited access to healthcare, namely uninsured and underinsured women, those in lower socioeconomic classes, and minorities. 3–5 As healthcare providers, we need to continue to advocate for health coverage for all patients so that they can receive the necessary preventive healthcare and decrease their risk of life-threatening diseases. Once women have access to cervical cancer screening, the next crucial step in decreasing cervical cancer incidence is ensuring follow-up of abnormal tests so precursor lesions can be treated before they progress to cancer. This has become increasingly complex with each new set of management guidelines, as diagnostic testing is stratified by patient age, previous test results, and current screening strategy (cytology alone, cytology+ HPV cotesting, and HPV subtyping). 6 The United States Health and Human Services Department endorses the electronic health record as a way to improve healthcare quality, safety, and efficiency. 7 Unfortunately the capabilities of the electronic health record are often underutilized. In this issue, MacLaughlin et al. 8 describe the effect of a clinical decision support system implemented at three Mayo Clinic-affiliated primary care clinics to electronically track abnormal Pap test results and missed patient appointments. These data are then used to prompt clinicians to generate electronic or letter patient reminders. Compared with historical controls, MacLauglin
