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Why Is the Electronic Health Record So Challenging for Research and Clinical Care?
Methods of Information in Medicine ( IF 1.7 ) Pub Date : 2021-07-19 , DOI: 10.1055/s-0041-1731784
John H Holmes 1 , James Beinlich 2 , Mary R Boland 1 , Kathryn H Bowles 3 , Yong Chen 1 , Tessa S Cook 4 , George Demiris 3 , Michael Draugelis 5 , Laura Fluharty 6 , Peter E Gabriel 4 , Robert Grundmeier 7 , C William Hanson 8 , Daniel S Herman 9 , Blanca E Himes 1 , Rebecca A Hubbard 1 , Charles E Kahn 4 , Dokyoon Kim 1 , Ross Koppel 10 , Qi Long 1 , Nebojsa Mirkovic 11 , Jeffrey S Morris 1 , Danielle L Mowery 1 , Marylyn D Ritchie 12 , Ryan Urbanowicz 1 , Jason H Moore 1
Affiliation  

Background The electronic health record (EHR) has become increasingly ubiquitous. At the same time, health professionals have been turning to this resource for access to data that is needed for the delivery of health care and for clinical research. There is little doubt that the EHR has made both of these functions easier than earlier days when we relied on paper-based clinical records. Coupled with modern database and data warehouse systems, high-speed networks, and the ability to share clinical data with others are large number of challenges that arguably limit the optimal use of the EHR

Objectives Our goal was to provide an exhaustive reference for those who use the EHR in clinical and research contexts, but also for health information systems professionals as they design, implement, and maintain EHR systems.

Methods This study includes a panel of 24 biomedical informatics researchers, information technology professionals, and clinicians, all of whom have extensive experience in design, implementation, and maintenance of EHR systems, or in using the EHR as clinicians or researchers. All members of the panel are affiliated with Penn Medicine at the University of Pennsylvania and have experience with a variety of different EHR platforms and systems and how they have evolved over time.

Results Each of the authors has shared their knowledge and experience in using the EHR in a suite of 20 short essays, each representing a specific challenge and classified according to a functional hierarchy of interlocking facets such as usability and usefulness, data quality, standards, governance, data integration, clinical care, and clinical research.

Conclusion We provide here a set of perspectives on the challenges posed by the EHR to clinical and research users.



中文翻译:

为什么电子健康记录对研究和临床护理如此具有挑战性?

背景 电子健康记录 (EHR) 已变得越来越普遍。与此同时,卫生专业人员一直在转向这一资源,以获取提供医疗保健和临床研究所需的数据。毫无疑问,当我们依赖纸质临床记录时,EHR 使这两个功能都变得更容易了。再加上现代数据库和数据仓库系统、高速网络以及与他人共享临床数据的能力,这些挑战可能会限制 EHR 的最佳使用

目标 我们的目标是为在临床和研究环境中使用 EHR 的人提供详尽的参考,同时也为设计、实施和维护 EHR 系统的卫生信息系统专业人员提供详尽的参考。

方法 本研究包括一个由 24 名生物医学信息学研究人员、信息技术专业人员和临床医生组成的小组,他们在 EHR 系统的设计、实施和维护方面或作为临床医生或研究人员使用 EHR 方面具有丰富的经验。该小组的所有成员都隶属于宾夕法尼亚大学的 Penn Medicine,并且拥有各种不同的 EHR 平台和系统以及它们如何随着时间的推移而发展的经验。

结果 每位作者都在 20 篇短文中分享了他们使用 EHR 的知识和经验,每篇短文都代表一个特定的挑战,并根据可用性和有用性、数据质量、标准、治理等互锁方面的功能层次进行分类、数据集成、临床护理和临床研究。

结论 我们在此就 EHR 给临床和研究用户带来的挑战提供了一组观点。

更新日期:2021-07-20
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