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首页> 外文期刊>BMC Medical Informatics and Decision Making >The role and benefits of accessing primary care patient records during unscheduled care: a systematic review
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The role and benefits of accessing primary care patient records during unscheduled care: a systematic review

机译：在计划外护理期间访问初级护理患者记录的作用和益处：系统回顾

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The purpose of this study was to assess the impact of accessing primary care records on unscheduled care. Unscheduled care is typically delivered in hospital Emergency Departments. Studies published to December 2014 reporting on primary care record access during unscheduled care were retrieved. Twenty-two articles met inclusion criteria from a pool of 192. Many shared electronic health records (SEHRs) were large in scale, servicing many millions of patients. Reported utilization rates by clinicians was variable, with rates >20% amongst health management organizations but much lower in nation-scale systems. No study reported on clinical outcomes or patient safety, and no economic studies of SEHR access during unscheduled care were available. Design factors that may affect utilization included consent and access models, SEHR content, and system usability and reliability. Despite their size and expense, SEHRs designed to support unscheduled care have been poorly evaluated, and it is not possible to draw conclusions about any likely benefits associated with their use. Heterogeneity across the systems and the populations they serve make generalization about system design or performance difficult. None of the reviewed studies used a theoretical model to guide evaluation. Value of Information models may be a useful theoretical approach to design evaluation metrics, facilitating comparison across systems in future studies. Well-designed SEHRs should in principle be capable of improving the efficiency, quality and safety of unscheduled care, but at present the evidence for such benefits is weak, largely because it has not been sought.
机译：这项研究的目的是评估访问初级护理记录对计划外护理的影响。计划外的护理通常由医院急诊科提供。检索到2014年12月发布的有关计划外护理期间访问初级护理记录的研究。 22篇文章符合192篇入选标准。许多共享的电子健康记录（SEHR）规模庞大，为数百万患者提供服务。临床医生报告的使用率是可变的，在健康管理组织中使用率> 20％，但在国家级系统中要低得多。尚无关于临床结局或患者安全性的研究报告，也未进行计划外护理期间SEHR接入的经济研究。可能影响利用率的设计因素包括同意和访问模型，SEHR内容以及系统可用性和可靠性。尽管SEHR规模庞大且费用昂贵，但其用于支持计划外护理的SEHR却未得到很好的评估，因此无法就使用它们可能带来的任何好处得出结论。系统之间的异质性及其所服务的总体使系统设计或性能的概括变得困难。所审查的研究均未使用理论模型指导评估。信息模型的价值可能是用于设计评估指标的有用理论方法，以利于将来研究中跨系统的比较。设计良好的SEHRs原则上应该能够提高计划外护理的效率，质量和安全性，但是目前这种益处的证据很薄弱，主要是因为尚未寻求。

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