Digital Health and the State of Interoperable Electronic Health Records
Digital Health and the State of Interoperable Electronic Health Records
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DOI：
10.2196/12712
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发表时间：
2019-10-01
影响因子：
3.2
通讯作者：
Shull, Jessica Germaine
中科院分区：
文献类型：
--
作者：
Shull, Jessica Germaine
数字医疗系统和这些系统内的创新医疗服务提供具有巨大的潜力，可以改善国家医疗保健，并对患者的健康结果产生积极影响。然而，目前，很少有国家拥有能够大规模实施数字干预的系统。这在一定程度上是因为缺乏可互操作的电子健康记录(EHR)。当个人或群体的数据分散在多个不兼容的系统上时，很难为该个人或群体做出决定。这篇观点论文强调了当前电子健康记录的一些关键障碍和一些有希望的成功，目标是促进电子健康记录的演变，并倡导开发服务于人群的数字医疗系统的框架--这是一个关键目标，因为我们进一步进入这个数据丰富的世纪，越来越多的患者寿命更长，依赖于资源可能已经紧张的医疗保健服务。本文旨在分析电子病历的演变、障碍和现状，并找出阻碍互操作性的基本领域。它还旨在突出已取得进展的国家，并从这些例子中提取最佳做法。电子健康记录互操作性的障碍并不容易解决，但要改善没有国家政策的国家目前的状况，就需要从公共和私营部门的各种来源集中调查解决办法。必须在国家范围内作出努力，寻求超越现状解决办法的最佳可互操作的电子病历的解决办法。提出了最佳做法的考虑事项清单。
Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations-a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.