Kushandisa mikana mitsva yekutarirwa kwehutano uye kubatana kwava chinhu chinonyanya kukosha kwehutano hwemazuva ano. Zviri kuwedzera zvakare nzira yatinosangana nayo nekudzivirira zvirwere. Vaya vanokurumidzira kushandisa mishonga yehutano-vose varwere uye vanachiremba-vachaona pakutanga vachibatsirwa nekufambira mberi uku.
Zvikwereti muElectroni Health Health Records Kubvumirwa
Kodhidhi yehutano yehutori (EHRs) iri kuwedzera kugamuchirwa kwose kweUnited States, iyo inofanana neHealth Information Technology ye Economic and Clinical Health Act (HITECH Act) yakapfuura muna 2009.
Uyu mutemo unoratidza kushandiswa kunobatsira kwekombiki yehutano uye inotsigira kushandiswa kweEHRs. Pakutanga, zvikwereti zvemari zvakapiwa kune vashandi vachishandisa EHRs, uye zvakagara zvataurwa kuti ikozvino kubvumirwa kwekugashira kwaizopedzisa. Muchikamu chekutanga cheHITECH Act, zvigaro zvingangodaro zvingave zvakabatanidzwa nemasangano ekuchengetedza hutano kwete kuratidza kushandiswa kunobatsira kwemazuva ano teknolojia yehutano yehutano pashure pegore ra2015. Zvisinei, kubvumirwa kwekutora kwave kuchirembera kudarika zvaitararisirwa, saka muna 2014, Centers for Medicare neMedicaid Services (CMS) yakashuma kuti danho rechitatu rekugadziriswa kwekugadziriswa rakanga radzingwa kusvikira muna 2017. Gore rakapera, kushandiswa kunoshandiswa kweEHRs kwakava sarudzo kune vose vanoita. Muna 2018, kushandiswa kwechikamu chechitatu chekugadziriswa kwakagadziriswa. Mamwe mapoka, zvisinei, akakumbira kuti danho rechitatu ridzoserwe zvakare nekuda kwezvinetso zvakagadziriswa pakati pevadzidzisi nevatengesi.
Kunyange zvakadaro, kwakave nekuwedzera kukuru mukushandiswa kweEHRs. Chidzidzo chakaitwa muna 2013 naMichael Furukawa uye coauthors vakawana kuti 78 muzana yevashandi vanoona nezvehofisi vakagamuchira mhando yeEHR. Kuwedzerwa kwemitengo yakagadziriswa kwaive kwakaderera mumabasa ega ega uye zvisati zvisiri zvekuchengetedza zvakanyanya, zvichiratidza kuti pane imwe nzvimbo yekuwedzera kukurudzirwa kwevanhu mune dzimwe nzvimbo.
Furukawa's data analysis yakaratidza zvakare kuti kuwedzerwa kwekushandisa zvinoshandiswa kwehutano hwehutano hwehutano kunogona kuderedza zviitiko zvinodhaka zvinodhaka muzvipatara, zvakadai sekukanganisa kwemishonga, kudarika uye kushandiswa kwevanhu. Mune imwe nhau yakabudiswa muna 2017 mu Journal of the American Medical Informatics Association, Furukawa nevamwe vashandi vakarondedzera kuti kupera kwe20 muzana yezviitiko zvinodhaka zvinodhaka zvinogona kuve zvichienderana nekushandiswa kunoshandiswa kweEHRs. Iyi ruzivo inogona kuita kuti zvipatara zvakawanda zvive neEHRs uye kudzivirira kushandiswa kwechiremba izvo zvichiri kuchinja kushandiswa kunobatsira.
Missing Opportunities
Kukundikana kukwana zvizere EHRs handiyo chete inetso inodzivisa hutano hwehutano. Dhiyabhorosi inounganidzwa muEHRs ine mikana yakawanda kupfuura yezvino inoshandiswa. Apo masangano aya anobvumira kusanganisa zvinhu zvakawanda zvemashoko, zviri nani zvakagadzirirwa kuunza maitiro ekugadzirisa maitiro maererano nehutano hwekurapa.
Tsvakurudzo dzinoverengeka dzakaedza izvi nzira yekuchengetedza chirwere cheshuga. Apo EHRs yakabatanidzwa nemakiriniki ekugadzirisa maitiro, urongwa hwakaratidzwa huri nani kupfuura ikozvino maitiro. Kubatanidza dunhu rega nehuwandu hwekufanotaura huwandu hwakapfuura kushanda kwemaitiro apfuura.
Yakapa kududzirwa zviri nani kwehurwere ruzivo pamwe nekuvandudzwa kwekutungamirirwa. Chidzidzo chakaitwa naDkt Michael Klompas weHarvard Medical School uye Harvard Pilgrim Health Care Institute muBoston akawanawo kuti EHR data inogona kubatsira kuona zvimwe zvirwere zveshuga uye kusarura pakati pemhando 1 uye chirwere cheshuga chechipiri. Klompas neboka rake vanotenda kuti teknolojia ino itsva ingashandiswa sehurongwa hwehutano hwehutano hwevanhu uye inogona kubatsira nekutungamira maitiro uye kurapa kwevarwere kune zvidzidzo zvekliniki.
Neemazuva ano EHRs, ruzivo runogona kuratidzika kuratidzika uye rupa boka rezvokurapa nekutarisira kwakakodzera uye kurapwa kwemishonga inorwara uye inogadziriswa kune mumwe murwere.
Chimwe chezvitsoropodzwa zvehuwandu hwehuwandu hwehutano hwekurapa ndezvekuti kupindira kwakanyatsogadziriswa pamusoro pevheji yekutanga kunotorwa kubva ku generalizations pamusoro pehuwandu hwevanhu. Iyi nzira inonyanya kuzivikanwa pasi pe- kana kupfuura-kubhadhara zvido zvemunhu. Uyezve, sarudzo yakagadziridzwa asi yakashandurwa nedzidziso inosimbisa kuti chirongwa chekutarisira kweumwe munhu uchapupu-hwakakosha uye hunonzwisisika. Mirayiridzo nemitemo zvinogara zvichishandurwa, izvo zvinogonesa kutarisirwa uye kusingagadziri kutarisirwa maererano nezvinodiwa zvakasiyana nemurwere. Pane humwe uchapupu hunoratidza kuti kuunganidza EHRs nemakiriniki ekutsigira sarudzo (CDSSs) inogona kugadzirisa hutano hwakanaka uye kushandura kuunganidza data mumashoko anoshanda.
Kombiyuta Kubatsira Varwere
Muna 2015, IBM neCVS Health vakazivisa kubatana kwekushandisa kushandisa simba guru rekuongorora shanduro yemakombiyuta eBMM Watson kuitira kuti vanhu vakwanise kutarisira vatengi veCVS. Kubatana kunoita kuti CVS iwedzere kutsvaga vatengi vangave vari pangozi yehutano husina kunaka uye vobva vapa maitiro akafanirwa kune avo vanowedzera mikana yekuvandudza hupenyu hwavo.
Watson Oncology, mutsva unyanzvi hwokugadzirisa maitiro, ikozvino kushandiswa neChemberero Sloan Kettering vanachiremba kuti vashandure kenza yevashandi vemakiriniki ezvinyorwa uye vanowana kurapa kwakanakisisa kunobva mumakore ehutano hwakachengetedzwa nekutsvakurudza. Izvi zvinoreva kuti uchapupu huchangobva kuitika hunogona kufamba nekukurumidza kuburikidza nevecology community uye kuvandudza kutarisira kwevarwere. Uyezve, inobatsirawo kuwedzera zivo kubva kune imwe nyanzvi kune imwe. Izvi zvingaita kuti uwane humwe hutano hwepamusoro-soro pasinei nokuti ndiani chiremba wako. Kufambiswa kwekuwedzera maitiro ehutano zvichibva pane zvakagadzirwa nehutano hwehutano hwehutano huchakurumidza kutevedzwa nevakwikwidzana, uye kungova kutanga kwekuwedzera kushandiswa kwenyanzvi yekugadzira kuvandudza hutano hwehuwandu hwevanhu. Kubatana pakati pemakambani akaita seBM uye makambani ezvokurapa uye emishonga vanogona kuvimbisa kuti zvigadzirwa zvinoshandiswa kune hutano hwezuva nezuva nekukurumidza.
Varwere Vanozvibatsira
Mumwe mukana mukuru unopiwa nehutachiona hwehutano hwehutano ndiyo mukana wekuwedzera kwehutano. Varwere vanogona kuona zvino, kutora uye kuwanika ruzivo rwehutano hwavo, pamwe nekuita zvisarudzo zvine ruzivo pamusoro pezvavanokwanisa kurapa. Michael Furokawa neboka rake revatsvakurudzi vakawana kuti vanachiremba vanowedzera kushandisa teknolojia yekugovana ruzivo nevarwere vavo. Muna 2014, 30 muzana yevanaongorori vaongorori vakashandisa zvigadziriro zvekutumira mameseji, uye 24 muzana nguva dzose vaipa varwere vane ruzivo rwekutsvaga pahutano hwehutano hwavo. Nhamba iyi inogona kunge yakawedzera mumakore akapfuura uye inogona kuwedzera varwere-chiremba kubatanidzwa.
Mazano matsva ari kuendeswa nguva yose yekuwedzera varwere kuita nekombiyuta. Mercy -a sangano rehutano rine zvirwere zvisingaperi zvinopinda purogiramu-pairi teknolojia pamwe nevadzidzisi vehutano. Vanodzidzisa vanoshandisa teknolojia yekubatsira kukurudzira varwere kuti vatange ivo pachavo uye kuti vawedzerwe zvakawanda mukuzvitarisira kwavo pachavo. Nenzira iyi, teknolojia yega haisi mhinduro. Kubatana kwevanhu kunobatsira kuchinja mafungiro uye kunotsigira kuchinja kwakanaka kwekuchinja, apo teknolojia inowedzera izvi. Kukurukurirana kwevanhu kunogona kuenderera mberi kuva chinhu chinokosha uye kuramba uchigadzirisa pamusoro pekubudirira kwezvibereko zvehutano, kunyange shanduko yekugadzirwa kwemagetsi inotibatsira kugadzirisa nenzira dzinokurumidza kufambira mberi uye kufambira mberi kubudirira kune huri nani huri nani.
> Sources
> Furukawa M, King J, Patel V, Chun-Ju H, Adler-Milstein J, Jha A. Pasinei nokufambira mberi kwakanyanya muhutano hweEHR, hutano hwezvehutano hwemashoko uye hutano hwevarwere hunoramba huri pasi muhutungamiri hwehupfumi. Utano , 2014; 33 (9): 1672-1679
> Furukawa M, King J, Patel V. Chiremba mafungiro ekusununguka kwekushandisa kweEHR maitiro ane chokuita nekushandiswa kunobatsira. American Journal of Managed Care , 2016; 21 (12): E684
> Furukawa M, Spector W, Limcangco M, Encinosa W, Rhona Limcangco M. Kushandisa zvinoshandiswa kwehutano hwehutano hwehutano uye kunopera muzviitiko zvezvipatara zvakashata. Nyaya yeAmerican Medical Informatics Association , 2017; 24 (4): 729-736.
> Klompas M, Eggleston E, McVetta J, Razaro R, Li L, Platt R. Kurongeka nekuona uye kusarudzwa kwechikwata 1 kurudzi rwechipiri chirwere cheshuga tichishandisa dhiyabhorosi rekodhi re data. Chirwere cheshuga . 2013; 36 (4): 914-921.