An exploratory study of networks constructed using access data from an electronic health record.
An exploratory study of networks constructed using access data from an electronic health record.
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DOI：
10.1080/13561820.2018.1496902
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发表时间：
2018-11
影响因子：
2.7
通讯作者：
Tu SP
中科院分区：
文献类型：
--
作者：
Yao N;Zhu X;Dow A;Mishra VK;Phillips A;Tu SP
网络分析可能是研究跨专业实践的有力工具。使用电子健康记录数据和社交网络分析，对大型城市学术医疗中心参与结直肠癌护理的医疗保健专业人员网络进行了绘制和研究。随机选取2013年和2014年接受治疗的手术结直肠癌患者100例。我们使用 EHR 的详细访问日志来绘制每位患者的所有医疗保健专业人员的网络，包括住院和门诊设置。分析了来自 6,800 多个唯一用户（代表 150 多个角色或职业）的大约 245 万条访问日志记录。在所有网络中，专业人士平均与 5.8 名其他专业人士有联系，但有些人很少与其他人联系，而超过 20 名专业人士的联系非常紧密（超过 100 名其他专业人士）。住院医生、主治医生和护士在全球网络中发挥着核心作用，拥有大量的专业间和专业内联系。频繁互动的专业人员集群已被证明，但根据网络的规模和复杂性，偶然的互动是不可能的。护理环境似乎会影响这些群体。以患者为中心的护理网络与全球网络相似，但存在一些潜在的重要差异。电子健康记录中的访问日志信息可能是有关医疗保健专业人员之间关系的重要信息来源。此类分析的结果可能有助于确定当前网络的状态以及提高护理质量的干预措施的潜在目标。
Network analysis may be a powerful tool for studying interprofessional practice. Using electronic health record data and social network analysis, the network of healthcare professionals involved in colorectal cancer care at a large, urban academic medical center were mapped and studied. A total of 100 surgical colorectal cancer patients receiving treatment in 2013 and 2014 were selected at random. We used detailed access logs for the EHR to map the network of all healthcare professionals for each patient, including inpatient and outpatient settings. Approximately 2.45 million records of access logs from more than 6,800 unique users, representing over 150 roles or occupations were analyzed. Across all networks, professionals were connected to an average of 5.8 other professionals, but some were rarely connected with others while over 20 were very highly connected (>100 other professionals). Housestaff, attending physicians, and nurses played central roles in the global network with a high number of inter- and intra-professional connections. Clusters of professionals with frequent interaction were demonstrated but, based on the size and complexity of the network, serendipitous interactions were unlikely. Settings for care seemed to influence these clusters. Patient-centric care networks were similar to the global network with some potentially important differences. Access-log information from electronic health records can be an important source of information about relationships between healthcare professionals. Findings from analyses such as this one may help define the state of current networks and potential targets for interventions to improve the quality of care.
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