AN OPEN, INTEROPERABLE, AND SCALABLE PREHOSPITAL INFORMATION TECHNOLOGY NETWORK ARCHITECTURE
AN OPEN, INTEROPERABLE, AND SCALABLE PREHOSPITAL INFORMATION TECHNOLOGY NETWORK ARCHITECTURE
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DOI：
10.3109/10903127.2010.534235
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发表时间：
2011-04-01
影响因子：
2.4
通讯作者：
Bogucki, Sandy
中科院分区：
文献类型：
--
作者：
Landman, Adam B.;Rokos, Ivan C.;Bogucki, Sandy
院前医疗中一些最棘手的挑战包括响应时间优化、急诊医疗服务（EMS）-急诊科（艾德）接口的效率低下以及将现场干预与患者结局相关联的能力。信息技术（IT）可以通过确保系统和患者信息在需要时随时随地接收，与之前和之后的患者信息完全集成，并安全存档，来解决这些问题和其他问题。一些EMS机构已经开始采用信息技术，如12导联心电图的无线传输，但很少有机构制定了一个全面的计划，管理其院前信息和与其他电子病历的整合。这篇透视文章强调了在没有战略计划的情况下集成IT元素的挑战和局限性，并提出了一个开放的、可互操作的和可扩展的院前信息技术（PHIT）架构。该PHIT架构的两个核心组件是：1）具有宽带网络连接的路由器，用于在救护车设备和EMS系统信息服务之间共享数据; 2）电子患者护理报告，用于组织和存档所有电子入院前数据。为了成功实施这种全面的PHIT架构，数据和技术要求必须基于最佳可用证据，并且系统必须遵守健康数据标准以及隐私和安全法规。最近的联邦立法优先考虑卫生信息技术可能会定位联邦机构，以帮助设计和资助PHIT架构。
Some of the most intractable challenges in prehospital medicine include response time optimization, inefficiencies at the emergency medical services (EMS)-emergency department (ED) interface, and the ability to correlate field interventions with patient outcomes. Information technology (IT) can address these and other concerns by ensuring that system and patient information is received when and where it is needed, is fully integrated with prior and subsequent patient information, and is securely archived. Some EMS agencies have begun adopting information technologies, such as wireless transmission of 12-lead electrocardiograms, but few agencies have developed a comprehensive plan for management of their prehospital information and integration with other electronic medical records. This perspective article highlights the challenges and limitations of integrating IT elements without a strategic plan, and proposes an open, interoperable, and scalable prehospital information technology (PHIT) architecture. The two core components of this PHIT architecture are 1) routers with broadband network connectivity to share data between ambulance devices and EMS system information services and 2) an electronic patient care report to organize and archive all electronic prehospital data. To successfully implement this comprehensive PHIT architecture, data and technology requirements must be based on best available evidence, and the system must adhere to health data standards as well as privacy and security regulations. Recent federal legislation prioritizing health information technology may position federal agencies to help design and fund PHIT architectures.