Liteko le Matšoenyeho a EMR le EHRs
Litlaleho tsa bongaka tse ngotsoeng ka letsoho tse ngotsoeng ka letsoho li fana ka litlaleho tsa lingaka tsa bongaka (EMRs). Le hoja litlaleho tsa bongaka tsa bongaka li 'nile tsa e-ba teng ka nako e ka bang lilemo tse 30, letlotlo la bohlokoa la lichelete lilemong tse leshome tse fetileng le entse hore ho be le mekhoa e metle le ho fumaneha ha nako e fetileng e sa fumanehe. Lebelo la ts'ebetso le tsoelo-pele ea EMR e ntse e eketseha, leha ho le joalo, ho ntse ho e-na le mathata a mangata a ho hlōla.
Ts'ebetsong ea mekhoa e mecha ea lits'ebeletso tsa bongaka e fumanoe ho nyatsoa ke baqolotsi ba litaba ba tlhokomelo ea bophelo le bahlalosi ka ho bonahala eka ha ba na boikarabello le boikarabello.
EHR vs. EMR
Li-acronyms tse peli-EHR le EMR-li atisa ho sebelisoa ka tsela e sa tšoaneng. Empa ha Ofisi ea Mohokahanyi oa Sechaba oa Tlhahlobo ea Boitsebiso bo Botle ba Bophelo (ONC) e hlokomela, ho na le phapang pakeng tsa litlaleho tsa bophelo bo botle ba elektronike (EHRs) le EMRs. EMRs predate EHRs mme e ne e reretsoe hore ngaka e sebelise feela. EHRs e leka ho fetela pele mme e akaretsa lintlha tse ngata ho feta li-EMR.
Tšebeliso e Molemo-e leng litekanyetso tse lokelang ho tiisa hore liranta tsa bophelo bo botle li sebelisitsoe ho EHRs li fella ka liphello tse hlahisoang-haholo-holo litaelo tsa hore li-EHR li se ke tsa kopanngoa. Tataiso ena e hloka ho bula lintlha tsa bophelo bo botle le ho kopanya mekhoa e fapaneng ea ho etsa mokhoa oa "ba bangata ho isa ho ba bangata" (ho fapana le "mohlala ho isa boemong") o neng o reretsoe ho eketsa tšebeliso ea lintlha tsa bongaka.
Leha ho le joalo, Fred Trotter, eo e leng moqolotsi oa litlaleho tsa litaba tsa bophelo bo botle le mongoli, o re li-EHRs ha li e-s'o khone ho fapanyetsana lintlha le ho buisana, kahoo tsamaiso ea tlhokomelo ea bophelo ea Amerika e ka 'na ea e-ba teng nakong ea li-EMR.
Ke'ng e thibelang tsamaiso ea bophelo bo botle?
Dr. Karen DeSalvo, Mookameli oa Naha oa Sechaba oa Theknoloji ea Boitsebiso bo Botle ba Bophelo, o ile a ngola ka litletlebo tsa "tlhahisoleseling ea bophelo bo botle" e thibelang phapanyetsano le tšebeliso ea tlhahisoleseding ea bophelo bo botle ea elektronike 'me ke e' ngoe ea mekoallo ea ho se sebetsane.
Le hoja babuelli ba bangata ba bophelo bo botle ba digital ba tšehetsa sepheo sa ho arolelana tlhahisoleseding e ka 'nang ea ntlafatsa tlhokomelo ea bongaka le ho boloka chelete, DeSalvo o re, "basebetsi ba bang lefapheng la tlhokomelo ea bophelo le bophelo bo botle ba IT ba susumelletseha haholo ho laola boitsebiso ba bophelo bo botle ba elektronike."
Ka April 2015, ONC e ile ea tlisa tlaleho ho Congress mabapi le boitsebiso bo thibelang, 'me bangoli ba etsa tlhahiso ea liketso tse ka thibelang mokhoa oo,' me tsa bolela hore ho lokela ho ba le pono e hlakileng ho marakeng a IT a bophelo bo botle.
Phuputso ea sechaba e entsoeng ke Julia Adler-Milstein le Eric Pfeifer oa Univesithing ea Michigan Likolo tsa Boitsebiso le Bophelo bo Botle ba Sechaba li bontšitse hore ho thibela boitsebiso bo ntse bo atile ho fihlela joale. Baahloli ba ile ba tlaleha hore barekisi, lipetlele le mekhoa ea bophelo bo botle ba atisa ho ba le boitsebiso bo thibelang litaba. Ho se kopane ha lihlahisoa tsa lihlahisoa ke e 'ngoe ea mefuta e tloaelehileng haholo ea mokhoa ona har'a barekisi. Leha ho le joalo, lipetlele le mekhoa ea bophelo bo botle li ne li fumanoa ho fana ka phekolo e khethehileng ho mofuta o itseng oa EHR le bafani ba qobelloang ho e amohela. Bahlahlobi ba ile ba boela ba bona lipetlele tse laolang ho phalla ha bakuli ka ho se arolelane boitsebiso ba bona pepeneneng.
Hape, ho susumetsoa ke mekhoa e joalo ke takatso ea ho eketsa chelete. Adler-Milstein le Pfeifer ba lumela hore tlhahiso-leseling e lokela ho ba molaong, e leng ho tla kenyelletsa ho kenyelletsa molao o mocha sebakeng sa phapanyetsano ea litaba le ho arolelana.
Tsela e 'ngoe e boletsoeng ho thibelano ea mefuta ea EMR e atlehileng ke motsoako o rarahaneng oa litaba tsa theknoloji le ho sebelisana ha leano. Trotter o ipiletsa ho lipetlele hore a iketsetse karolo e khethehileng ea ho sebetsana le litaba tsena tse khethehileng.
Kaofela hohle, ho sebelisana ha tsona ho ntse ho le thata. Litsebi tse ngata tsa tlhokomelo ea bophelo bo botle li lumela hore mekoallo ea ho kenya ts'ebetsong ha e e-s'o tlosoe leha ho le joalo ho sa tsotellehe cheseho ea pele le lisebelisoa tse kentsoeng morero.
Ho ikamahanya ha Li-EMR
Ho khoneha ha dintlha tsa bophelo bo botle ba motho ke ntlha e 'ngoe ea bohlokoa e amanang le ho bōpa melao-motheo pakeng tsa lirekoto tsa bophelo bo botle le bokhoni ba ho tsamaisa boitsebiso bona habonolo tsamaisong e sa tšoaneng. Liphuputso tse ngata li bontšitse hore lintlha tse khonehang le tse bonolo tse fetisoang li ka ntlafatsa haholo litšebeletso tsa tlhokomelo ea bophelo le ho ntlafatsa tlhokomelo ea bakuli. Leha ho le joalo, ho khoneha ha li-EMR ke phephetso e sa kang ea rarolloa leha ho le joalo ebile e sa ntse e hloka ho phethahala ho boloka tsamaiso ea tlhokomelo ea bophelo bo botle.
Phetoho e sireletsehileng le e sireletsehileng ea tlhahisoleseling ea bophelo bo botle ba lefapha e ntse e le e 'ngoe ea lintho tse tlang pele bophelong ba mokhatlo oa bophelo bo botle ba lefapha. Bafuputsi ba India ba neng ba hlahloba ho kenya ts'ebetsong ha EHR linaheng tse tsoetseng pele ba entse tlhahiso ea hore polokelo ea leru, tšireletso ea motsoako, le ho koetlisa bohle ba lekanyetsa bafani ba tlhokomelo ea bophelo ba ka e etsang ho etsa hore li-EHR tse nkiloeng li sireletsehe haholoanyane. Litlōlo tse ling tsa ts'ireletso le mekhoa ea boitšoaro li ngotsoe 'me ka linako tse ling li koahetse molemo oa EHRs.
Ho koala bophelo bo botle
E le ho ntlafatsa tlhahiso ea tlhahisoleseding ea bophelo bo botle, ka la 28 July, 2015, ONC e phatlalalitse chelete e fetang liranta tse limilione tse limilione tse 38 ho fana ka liphallelo ho mekhatlo e 20 e tsoang linaheng tse 19 naheng ka bophara. Ntho e 'ngoe eo litlhōlo li neng li lebeletsoe hore li sebetse ho tsona e ne e le ho eketsa ho kopanngoa ha boitsebiso ba bophelo bo botle Lenaneo la bophelo bo botle ba lithaka tsa sechaba le lona le ne le boletse hore ho tla thusa sechaba ho ntlafatsa tlhahiso ea data, tlhahiso ea data le tlhahlobo ea lintlha, bohle ba nang le sepheo sa ho finyella liphello tse molemo le ho sebelisa chelete e hlokolosi ea tlhokomelo ea bophelo.
Mananeo a mang a boetse a behiloe ho kopanyelletsa bakuli le ho ntlafatsa ts'ebeliso ea tlhokomelo, joalo ka Mananeo a Khothalletsang Batho ba Etsoang ke Medicare le Medicaid EHR. Ts'ebetso tsena li khothalletsa phapanyetsano e sireletsehileng ea tlhahisoleseling ea bophelo bo botle Ba boetse ba khothaletsa ho fumana mamello ho lirekoto le lisebelisoa tsa elektronike ho thusa ho buisana le bafani ba bophelo bo botle. Sepheo sa kakaretso ea lenaneo ke ho fokotsa mefokolo ea bophelo bo botle le ho fana ka tlhokomelo ea moetlo e nang le bokhoni ka thuso ea thekenoloji. Tlhahlobo ea morao-rao ea Lenaneo la Khumamelo la EHR le Lefapha la Bophelo ba Informatics le Phatlalatso ea Boitsebiso ea Koleji ea St. Scholastica e bontšitse hore ntshetsopele e kholo e entsoe. Leha ho le joalo, e le hore e be baetapele ba eketsehileng le ho ntlafatsa liphello tsa tlhokomelo bakeng sa bohle, ho kopanela mosebetsing ho ntse ho hloka tlhokomelo e eketsehileng.
> Mohloli
> Adler-Milstein J, Pfeifer E. Thibelo ea Boitsebiso: Na e Etsahala le Mekhoa efe ea Leano e ka e Bitsang? . Milbour Quarterly . 2017; (1): 117-135
> Ozair FF, Jamshed N, Sharma A, Aggarwal P. Litaba tsa boitšoaro litlalehong tsa bophelo bo botle ba elektronike: Tlhaloso e akaretsang. Sepheo ho Patlisiso ea Bongaka . 2015; 6 (2): 73-76
> Terry K. Ho ntse ho letile: ke hobane'ng ha ho ts'oaroa ha EHR e ntse e le pakane e thata. Boemo ba Meriana . 2017; (11): 14-19.
> Ho chesa F. Ke eng e ka sebelisang molemo ho Ithuta ho tsoa Healthcare.gov ?. The Health Care Blog , la 2 Ntlha ea 2015. http://thehealthcareblog.com/blog/2015/03/02/what-can-meaningful-use-learn-from-healthcare-gov
> Watters A, Bergstrom A, Sandefer R. Patient molekane le tšebeliso e sebetsang: Ho lekanya phello ea lenane la ts'ehetso la EHR ka litsebo tsa setso litabeng tsa bophelo bo botle. Litaba tsa Tloaeleho ea Bolumeli . 2016; 23 (3): 114-120.