electronic medical records system

  • 文章类型: Preprint
    许多数字健康干预措施(DHIs),包括移动健康(mHealth)应用程序,旨在提高客户的结果和效率,如电子病历系统(EMRS)。尽管互操作性是黄金标准,它也是复杂和昂贵的,需要技术专长,利益相关者权限,和持续的资金。手动数据链接过程通常用于跨系统“集成”,并允许评估DHI影响,最佳实践,在进一步投资之前。对于mHealth,手动数据联动工作量,包括相关的监测和评估(M&E)活动,仍然知之甚少。
    作为一项开源应用程序的基线研究,该应用程序可以反映EMRS并减少医护人员(HCW)的工作量,同时改善由护士领导的基于社区的抗逆转录病毒治疗计划(NCAP)的护理。马拉维,我们进行了时间运动研究,观察HCWs完成数据管理活动,包括常规M&E和个人级别应用程序数据到EMRS的手动数据链接。数据管理任务应该通过成功的应用程序实施和EMRS集成来减少或结束。在Excel中分析数据。
    我们观察到69:53:00的HCWs执行常规NCAP服务交付任务:39:52:00(57%)用于完成M&E数据相关任务,其中15:57:00(23%)用于手动数据链接工作负载,独自一人。
    了解工作负载以确保高质量的M&E数据,包括完成mHealth应用程序到EMRS的手动数据链接,为利益相关者提供投入,以推动DHI创新和集成决策。量化潜在的mHealth益处,提高效率,高质量的M&E数据可能会引发新的创新,以减少工作量并加强证据以刺激持续改进。
    UNASSIGNED: Many digital health interventions (DHIs), including mobile health (mHealth) apps, aim to improve both client outcomes and efficiency like electronic medical record systems (EMRS). Although interoperability is the gold standard, it is also complex and costly, requiring technical expertise, stakeholder permissions, and sustained funding. Manual data linkage processes are commonly used to \"integrate\" across systems and allow for assessment of DHI impact, a best practice, before further investment. For mHealth, the manual data linkage workload, including related monitoring and evaluation (M&E) activities, remains poorly understood.
    UNASSIGNED: As a baseline study for an open-source app to mirror EMRS and reduce healthcare worker (HCW) workload while improving care in the Nurse-led Community-based Antiretroviral therapy Program (NCAP) in Lilongwe, Malawi, we conducted a time-motion study observing HCWs completing data management activities, including routine M&E and manual data linkage of individual-level app data to EMRS. Data management tasks should reduce or end with successful app implementation and EMRS integration. Data was analysed in Excel.
    UNASSIGNED: We observed 69:53:00 of HCWs performing routine NCAP service delivery tasks: 39:52:00 (57%) was spent completing M&E data related tasks of which 15:57:00 (23%) was spent on manual data linkage workload, alone.
    UNASSIGNED: Understanding the workload to ensure quality M&E data, including to complete manual data linkage of mHealth apps to EMRS, provides stakeholders with inputs to drive DHI innovations and integration decision making. Quantifying potential mHealth benefits on more efficient, high-quality M&E data may trigger new innovations to reduce workloads and strengthen evidence to spur continuous improvement.
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  • 文章类型: Journal Article
    人工智能(AI)取得了重大进展,重塑各行各业,包括医疗保健。2022年11月,OpenAI推出ChatGPT标志着一个关键时刻。展示了生成AI在彻底改变患者护理方面的潜力,诊断和治疗。生成AI,与传统的人工智能系统不同,拥有通过理解数据集内的模式来生成新内容的能力。本文探讨了人工智能在医疗保健领域的演变,追溯到约翰·麦卡锡(JohnMcCarthy)在1955年创造的术语,以及约翰·冯·诺依曼(JohnVonNeumann)和艾伦·图灵(AlanTuring)等先驱的贡献。目前,生成式AI,特别是大型语言模型,在医疗保健领域拥有三大类的承诺:患者护理,教育和研究。在病人护理中,它提供临床文档管理解决方案,诊断支持和手术计划。值得注意的进步包括微软与Epic合作,将AI集成到电子病历(EMR)中。加强临床数据管理和患者护理。此外,生成AI有助于手术决策,正如在塑料中所证明的,骨科和肝胆手术。然而,偏见等挑战,幻觉和与EMR系统的集成需要谨慎和持续的评估。本文还介绍了NUHSRussell-GPT实施的见解,一个生成的AI聊天机器人,在手外科,展示其在管理任务中的实用性,但突出了手术计划和EMR集成方面的挑战。调查显示,一致支持将人工智能纳入临床环境,所有受访者都愿意使用它。总之,生成AI有望增强患者护理并减轻医生的工作量,从自动化管理任务开始,发展到为诊断提供信息,量身定制的治疗计划,以及手术计划的帮助。随着医疗保健系统驾驭人工智能集成的复杂性,对医生和患者的潜在好处仍然很大,让我们瞥见人工智能改变医疗保健交付的未来。证据级别:V级(诊断)。
    Artificial intelligence (AI) has witnessed significant advancements, reshaping various industries, including healthcare. The introduction of ChatGPT by OpenAI in November 2022 marked a pivotal moment, showcasing the potential of generative AI in revolutionising patient care, diagnosis and treatment. Generative AI, unlike traditional AI systems, possesses the ability to generate new content by understanding patterns within datasets. This article explores the evolution of AI in healthcare, tracing its roots to the term coined by John McCarthy in 1955 and the contributions of pioneers like John Von Neumann and Alan Turing. Currently, generative AI, particularly Large Language Models, holds promise across three broad categories in healthcare: patient care, education and research. In patient care, it offers solutions in clinical document management, diagnostic support and operative planning. Notable advancements include Microsoft\'s collaboration with Epic for integrating AI into electronic medical records (EMRs), enhancing clinical data management and patient care. Furthermore, generative AI aids in surgical decision-making, as demonstrated in plastic, orthopaedic and hepatobiliary surgeries. However, challenges such as bias, hallucination and integration with EMR systems necessitate caution and ongoing evaluation. The article also presents insights from the implementation of NUHS Russell-GPT, a generative AI chatbot, in a hand surgery department, showcasing its utility in administrative tasks but highlighting challenges in surgical planning and EMR integration. The survey showed unanimous support for incorporating AI into clinical settings, with all respondents being open to its use. In conclusion, generative AI is poised to enhance patient care and ease physician workloads, starting with automating administrative tasks and evolving to inform diagnoses, tailored treatment plans, as well as aid in surgical planning. As healthcare systems navigate the complexities of integrating AI, the potential benefits for both physicians and patients remain significant, offering a glimpse into a future where AI transforms healthcare delivery. Level of Evidence: Level V (Diagnostic).
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  • 文章类型: Journal Article
    Cumulative data on patient fall risk have been compiled in electronic medical records systems, and it is possible to test the validity of fall-risk assessment tools using these data between the times of admission and occurrence of a fall. The Hendrich II Fall Risk Model scores assessed during three time points of hospital stays were extracted and used for testing the predictive validity: (a) upon admission, (b) when the maximum fall-risk score from admission to falling or discharge, and (c) immediately before falling or discharge. Predictive validity was examined using seven predictive indicators. In addition, logistic regression analysis was used to identify factors that significantly affect the occurrence of a fall. Among the different time points, the maximum fall-risk score assessed between admission and falling or discharge showed the best predictive performance. Confusion or disorientation and having a poor ability to rise from a sitting position were significant risk factors for a fall.
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  • 文章类型: Journal Article
    背景:电子病历系统(EMRS)是安全访问患者数据并提高医疗保健质量的有价值的系统。人力是EMRS的要求之一,其中经理是医院里最重要的人。考虑到经理的积极态度和良好的承诺,EMRS将成功实施。因此,我们决定在2014年评估伊斯法罕医院经理对EMRS的态度和承诺。
    目的:本文旨在确定医院管理者对实施EMRS的态度和承诺。
    方法:本文为应用分析研究。研究协会由伊斯法罕所有医院的管理人员组成,其中包括伊斯法罕医科大学附属医院,私人,社会保障医院。这项研究是在2014年完成的。数据收集工具包括确定信度和效度的问卷。采用SPSS20对数据进行分析。
    结果:伊斯法罕市经理对EMRS的态度平均得分为100分中的77.5分,他们的承诺平均得分为74.7分。管理者对社会保障医院的态度比私营和政府的态度更为积极(83.3%)。此外,社会保障医院管理人员的承诺额高于私立和公立医院的承诺额(86.6%)。
    结论:目前,伊斯法罕医院的管理者对EMRS的态度和承诺非常高,社会保障医院在这方面表现出更多的准备。
    BACKGROUND: Electronic medical record system (EMRS) is a valuable system for safe access to the patient\'s data and increases health care quality. Manpower is one of the requirements for EMRS, among which manager is the most important person in any hospital. Taking into account manager\'s positive attitude and good commitments, EMRS will be implemented successfully. As such, we decided to assess manager\'s attitude and commitment toward EMRS in Isfahan hospitals in the year of 2014.
    OBJECTIVE: This article aimed to determine the hospital managers\' attitude and commitment toward the implementation of EMRS.
    METHODS: The present article is an applied analytic study. Research society consisted of the managers of all the hospitals in Isfahan that include hospitals affiliated to Isfahan University of Medical Sciences, private, and social security hospitals. This study was done in 2014. Data collection tools included a questionnaire for which reliability and validity were determined. Data were analyzed by means of SPSS 20.
    RESULTS: Average score for the managers\' attitude toward EMRS in the city of Isfahan was 77.5 out of 100 and their average score for commitment was 74.7. Manager\'s attitude in social security hospitals was more positive than the private and governmental ones (83.3%). In addition, the amount of commitment by the managers in social security hospitals was higher than the same in private and governmental hospitals (86.6%).
    CONCLUSIONS: At present, managers\' attitude and commitment in Isfahan hospitals toward EMRS are very high and social security hospitals show more readiness in this respect.
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