研究显示电子病历减少医疗事故
2012-08-04 18:38:02   来源：37度医学网   作者：  评论：0 点击：

1.EHRs could mean fewer malpractice claims

研究显示电子病历减少医疗事故

2.BOSTON - A study by Harvard Medical School-affiliated researchers, published in June in the Archives of Internal Medicine, showed that Massachusetts physicians who used electronic health records saw a reduction in malpractice claims.

波士顿，一个哈佛医学院的研究发表在6月的《内科学纪要》上，研究提示使用电子病历的马萨诸塞州医生医疗事故索赔下降。

3.Correlation does not imply causation, of course. But the report's authors say their findings suggest, "implementation of EHRs may reduce malpractice claims and, at the least, appears not to increase claims as providers adapt to using EHRs."

当然，相关性不意味着因果关系。但该报告的作者说，他们的研究结果表明，电子病历的实施可能降低医疗事故索赔，至少，使用电子病历似乎没有增加医疗事故的索赔之出。

4.The study, titled "The Relationship Between Electronic Health Records and Malpractice Claims," was written by Mariah A. Quinn, MD; Allyson M. Kats; Ken Kleinman; David W. Bates, MD; Steven R. Simon, MD.

这项题为《电子病历与医疗事故纠纷的关系》的研究，作者是Mariah A. Quinn, MD; Allyson M. Kats; Ken Kleinman; David W. Bates, MD; Steven R. Simon, MD。

5."Given the potential of EHRs to reduce adverse events and health care costs, the question of whether EHRs reduce the risk of malpractice lawsuits is a logical one," they write.

他们提到，“鉴于电子病历潜在降低医疗事故和医疗卫生支出，降低医疗事故诉讼是合理必然的。”

6."Risk factors for medical error and resultant malpractice claims, including poor communication between providers, difficulty in accessing patient information in a timely manner, unsafe prescribing practices, and lower adherence to clinical guidelines, may be ameliorable by health information technology," the report notes. "The high quality and availability of proper documentation in EHRs may increase the likelihood of successful defense against malpractice claims."

研究中也提到，“医疗事故和作为结果的医疗事故索赔的危险因素，包括提供医疗者糟糕的沟通，难以及时获得病人的信息，不安全的处方和临床指南低实施率，可以被卫生信息技术所改善。提供适当高质量文件的电子病历可以增加成功防范医疗事故索赔的可能性。”

7.For this study, the researchers assessed groups of Massachusetts physicians who had previously been surveyed in 2005 and 2007 - tracking their malpractice claims over time.

在这项研究中，研究人员通过时间跟踪，评估了曾在2005和2007年有余医疗事故被调查的马萨诸塞州的医生。

8."Because physicians in the sample were insured for different durations and used EHRs for variable amounts of time, the number of insured years was calculated for each physician before and after EHR adoption," they write. "We used Poisson regression to determine whether EHR use was associated with malpractice claims, modeling the rate of malpractice claims per year in periods with and without EHRs and adjusting for clustering by physician. We used the generalized linear mixed models version of Poisson regression to account for correlation between periods."

他们写道，“因为在这个样本中的医生已经为确保不同时间并且大部分时间使用电子病历，使用电子病历前后的年数是可以计算的。我们使用泊松回归确定使用电子病历与医疗事故索赔是否有关，通过每年医疗事故索赔建模率，调整使用与不使用电子病历的医生群体。”

9.Of the 189 doctors surveyed in both 2005 and 2007, they note, 27 were named in at least one malpractice claim. Overall, 33 of the 275 physicians from multiple surgical and medical specialties who responded in 2005 and/or 2007 incurred a total of 51 unique claims. Forty-nine of those claims were related to events occurring before EHR adoption. Two were related to events occurring after EHR adoption.

他们提到，在2005和2007年一共有189名医生被调查，有27名医生至少经历一起医疗事故索赔。总体上，来自多种手术和专科275名医生中有33名要为在2005年和（或）2007年共发生的51起独立索赔负责。其中49起发生在使用电子病历之前，2起发生在使用电子病历之后。

10."We found that the rate of malpractice claims when EHRs were used was about one-sixth the rate when EHRs were not used," the researchers write. "This study adds to the literature suggesting that EHRs have the potential to improve patient safety and supports the conclusions of our prior work, which showed a lower risk of paid claims among physicians using EHRs. By examining all closed claims, rather than only those for which a payment was made, our findings suggest that a reduction in errors is likely responsible for at least a component of this association, since the absolute rate of claims was lower post-EHR adoption."

研究人员写道，“我们发现医疗事故索赔率使用电子病历是不使用电子病历的1/6。添加到文献中的这项研究表明电子病 历有可能改善病人的安全性并且我们前期的工作支持我们的结论，这就是应用电子病历能够降低医疗纠纷索赔的风险。通过回顾所有已经结束的案件，而不是仅仅回 顾实行了索赔的案件，我们发现电子病历至少是医疗事故的降低的一部分因素，因为显而易见使用电子病历后医疗事故索赔率下降。

11.The report does concede that other factors may be at work. "For example, physicians who were early adopters of EHRs may exhibit practice patterns that make them less likely to have malpractice claims, independent of EHR adoption; these early adopters contribute a disproportionate amount of time in our analyses, favoring an effect of EHRs on reducing malpractice claims."

报告也承认可能是工作中的其他因素。“例如，早期使用电子病历的医生可能被展示给其他医生从而降低他们的医疗事故索赔，而非独立使用电子病历；在我们的分析中这些早期的事例不成比例的大量出现，倾向于电子病历可以降低医疗事故索赔。”

12.Still, they argued, despite the small sample size, the reduction in malpractice claims shown in the EHR study "lends support to the push for widespread implementation of health information technology."

尽管样本数量小，他们仍然坚持，电子病历减少医疗事故索赔的研究可以支持推广医疗信息技术是使用。