Data Flow & Clinical Outcomes in a Perinatal Continuum of Care System

描述（由申请人提供）：卫生信息技术（HIT）现在处于卫生保健改善议程的前沿，因为它有可能实现减少医疗差错和提高患者安全，这是改善临床结果和效率所必需的。我们正在研究利哈伊谷健康网络（LVHN）在其妇产科实践小组和网络主要医院的分娩和分娩（L&D）部门实施一种特定的HIT应用程序，这是一种综合电子病历（EMR）系统。在此过程中，每个实践组都迁移到单个供应商提供的电子病历，这些电子病历将与医院L&D部门新升级的系统相关联，形成一个集成的电子病历。一旦安装了该系统，当患者到达L&D时，每个医生办公室的医疗信息将立即可用，并且患者访问L&D的信息将被发送回办公室。我们的目标是使用定性和定量方法来评估该系统的影响，以便我们能够充分评估综合EMR的能力，以解决在围产期连续护理的关键临床点向医生和临床工作人员提供准确，完整和及时的数据的公认失败。我们有四个具体目标：目标1：发展有根据的理论，通过对技术接受和使用的定性分析，以及互补的组织和流程变化，描述供应商提供的门诊电子病历系统与医院信息系统的有效实施和集成过程。目标2：定量检查采用综合电子病历系统后医院和个人实践中数据完整性（完整和可访问的数据）的变化。目标3：从数量上审查在健康结果、工作人员对患者安全的看法、患者和医务人员满意度方面的改进，以及初级保健和住院医生生产力方面的变化。目标4：使用混合方法，对定量和定性分析的结果进行三角测量，以更深入地了解如何从综合电子病历中获益。

DESCRIPTION (provided by applicant): Health information technology (HIT) is now at the forefront of the health care improvement agenda because of its potential to achieve the reductions in medical errors and increases in patient safety necessary to improve clinical outcomes and efficiency. We are studying the implementation by the Lehigh Valley Health Network (LVHN) of a particular HIT application, an integrated electronic medical record (EMR) system, at its OB/GYN practice groups and the Labor and Delivery (L&D) Unit at the network's main hospital. In this process, each of the practice groups is migrating to a single, vendor-supplied, EMR, and these EMRs will be linked to a newly-upgraded system at the hospital's L&D Unit to form an integrated EMR. Once the system is installed, medical information from each physician office will be immediately available when a patient arrives at L&D, and information from a patient's visits to L&D will sent back to the office. Our goal is to use both qualitative and quantitative methods to evaluate the impact of this system, so that we can fully assess the ability of an integrated EMR to address a recognized failure to deliver accurate, complete, and timely data to physicians and clinical staff at critical clinical points along the perinatal continuum of care. We have four specific aims: Aim 1: Develop grounded theory to describe the process of effective implementation and integration of vendor-supplied ambulatory EMR systems with hospital information systems through qualitative analysis of technology acceptance and use, and complementary organizational and process changes. Aim 2: Examine quantitatively the change in data completeness (complete and accessible data) at the hospital and at the individual practices resulting from the adoption of the integrated EMR system. Aim 3: Examine quantitatively improvements in health outcomes, staff perceptions of patient safety, and patient and medical staff satisfaction, as well as changes in the productivity of primary care and inpatient physicians. Aim 4: Using mixed methods, triangulate the results of the quantitative and qualitative analyses to gain a deeper understanding of how to achieve benefits from an integrated EMR.