Using information systems to measure and improve quality
Using information systems to measure and improve quality
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DOI：
10.1016/s1386-5056(98)00152-x
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发表时间：
1999-02-01
影响因子：
4.9
通讯作者：
Teich, JM
中科院分区：
文献类型：
--
作者：
Bates, DW;Pappius, E;Teich, JM
信息系统(IS)对于衡量和提高质量越来越重要。在本文中，我们描述了我们的集成交付系统的计划和使用IS测量和改进质量的经验。我们的信念是，为了使质量测量切实可行，它必须与常规护理服务相结合，并在可能的情况下使用IS进行。因此，在一家医院，我们现在几乎所有的质量测量都使用IS。我们还在建设一个临床数据仓库，它将成为整个网络中高质量信息的储存库。然而，信息系统不仅对衡量医疗保健有用；而且还代表着使用决策支持改善医疗保健的强大工具。我们已经看到显著好处的具体领域包括减少不必要地使用实验室测试，向关键供应商迅速报告重要异常情况，预防和检测不良药物事件，主动改变处方模式以降低药品成本，以及向供应商提供关键途径。我们的下一个主要努力将是在更广泛的基础上引入计算机化的指导方针，这将是具有挑战性的。然而，管理式医疗在美国的出现产生了以低成本提供高质量医疗服务的强烈动机，我们的观点是，只有在比目前存在的更好的情况下，才能在不影响质量的情况下实现这一点。这样的系统使质量衡量、改善护理和降低成本倡议的实施变得可行，其规模是以前无法考虑的。(C)1999爱思唯尔爱尔兰科学有限公司。保留所有权利。
Information systems (IS) are increasingly important for measuring and improving quality. In this paper, we describe our integrated delivery system's plan for and experiences with measuring and improving quality using IS. Our belief is that for quality measurement to be practical, it must be integrated with the routine provision of care and whenever possible should be done using IS. Thus, at one hospital, we now perform almost all quality measurement using IS. We are also building a clinical data warehouse, which will serve as a repository for quality information across the network. However, IS are not only useful for measuring care; but also represent powerful tools for improving care using decision support. Specific areas in which we have already seen significant benefit include reducing the unnecessary use of laboratory testing, reporting important abnormalities to key providers rapidly, prevention and detection of adverse drug events, initiatives to change prescribing patterns to reduce drug costs and making critical pathways available to providers. Our next major effort will be introduce computerized guidelines on a more widespread basis, which will be challenging. However, the advent of managed care in the US has produced strong incentives to provide high quality care at low cost and our perspective is that only with better IS than exist today will this be possible without compromising quality. Such systems make feasible implementation of quality measurement, care improvement and cost reduction initiatives on a scale which could not previously be considered. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.