Mayesero ndi Masautso a EMRs ndi EHRs
Zolemba zachipatala zolembedwa pamanja zimapereka mauthenga a zamankhwala (EMRs). Ngakhale kuti zolemba zachipatala zakhala zikuzungulira kwa zaka zosachepera 30, ndalama zamtengo wapatali pazaka 10 zapitazi zachititsa kuti pakhale deta komanso zowonjezera zomwe poyamba zinalibe. Kupititsa patsogolo mphamvu zatsopano komanso kupita patsogolo kwa EMRs kukuwonjezeka, komabe, pali zovuta zambiri kuti zithetse.
Kukhazikitsidwa kwa machitidwe atsopano a zachipatala adalandira kutsutsidwa kwina kuchokera kwa atolankhani a zachipatala ndi owonetsa ndondomeko chifukwa chowoneka kuti alibe chifukwa choyankha ndi kuwapatsa mphamvu.
EHR vs. EMR
Zithunzi ziwiri-EHR ndi EMR-zimagwiritsidwa ntchito mosasinthasintha. Koma monga ofesi ya National Coordinator for Health Information Technology (ONC), pali kusiyana pakati pa mauthenga a zaumoyo (EHRs) ndi EMRs. EMRs predate EHRs ndipo ankafuna kuti ogwiritsira ntchito kokha. EHRs amayesa kupita patsogolo ndipo akuphatikizitsa chiwerengero chachikulu cha deta kuposa EMRs.
Kugwiritsira Ntchito Mwakhama - Makhalidwe omwe akuyenera kuonetsetsa kuti ndalama zomwe amagwiritsira ntchito pa EHRs zimabweretsa zotsatira zopindulitsa -zofunikira kwambiri kuti EHRs ikhale yosagwirizana. Lamuloli likufuna kutsegula deta ya dokotala ndikugwirizanitsa machitidwe osiyanasiyana opanga "ambiri mpaka ambiri" chitsanzo (mosiyana ndi "mfundo ndi mfundo") pofuna kuwonjezera kufunika kwa deta ya munthu.
Komabe, Fred Trotter, mtolankhani wolemba za deta komanso wolemba mabuku, ananena kuti EHRs silingathe kusinthanitsa deta ndi kulankhulana, kotero kuti dongosolo la chisamaliro cha America likhoza kukhalabe pa nthawi ya EMRs.
Nchiyani chomwe chimaletsa dongosolo la thanzi losagwirizana?
Dr. Karen DeSalvo, yemwe kale anali Mtsogoleri Wadziko Lonse wa Health Information Technology, analemba za madandaulo a "zokhudzana ndi thanzi labwino." Chizoloŵezi chimenechi chimalepheretsa kusinthanitsa ndi kugwiritsa ntchito mauthenga a zaumoyo zamagetsi ndipo ndi chimodzi mwa zolepheretsa kusagwirizana.
Ngakhale adokotala ambiri a zachipatala akuthandizira cholinga cha kugawana nzeru zomwe zingatheke kukonza chithandizo chamankhwala ndi kusunga ndalama, DeSalvo akuti, "anthu ena omwe akugwira nawo ntchito zaumoyo ndi thanzi la IT ali ndi zifukwa zolimbikitsana kuti azigwiritsa ntchito mphamvu zamagetsi pa zamagetsi."
Mu April 2015, bungwe la ONC linapereka lipoti ku Congress pazomwe likudziwitsidwa, ndipo olembawo adalimbikitsa ntchito zomwe zingathe kulepheretsa chizoloŵezichi, ndipo adanena kuti payenera kukhala owonetsetsa bwino misika ya IT.
Julia Adler-Milstein ndi Eric Pfeifer omwe adafufuza kafukufuku wina wa yunivesite ya Michigan, Schools of Information and Public Health, adawonetsa kuti chidziwitso chodziwikiratu chimafalikirabe mpaka lero. Otsutsawo anafotokoza kuti ogulitsa, zipatala ndi machitidwe a zaumoyo nthawi zonse amachita nawo chidziwitso. Kusagwirizanitsa kochepa kwa malonda kunali imodzi mwa mitundu yowonjezereka ya chichitidwe ichi pakati pa ogulitsa. Mzipatala ndi machitidwe a zaumoyo, nthawi zambiri, zimapezeka kuti zimapereka chithandizo choyenera kwa mtundu wina wa EHR ndi ogwira ntchito oponderezedwa kuti awulandire. Otsutsawo anaonanso zipatala zomwe zikuyendetsa odwala mwa kusagawana nawo chidziwitso chawo.
Chotsatira, cholinga cha miyambo imeneyi chinali chikhumbo chowonjezera ndalama. Adler-Milstein ndi Pfeifer amakhulupirira kuti mfundo zotsutsana ziyenera kukhala zoletsedwa, zomwe zingaphatikizepo kukhazikitsa malamulo atsopano m'malo mwa kusinthanitsa deta ndi kugawa.
Chinthu china chomwe chinatchulidwa kuti "EMRs" yothandizana bwino ndi kusakanikirana kovuta kwa nkhani zamakono ndi kuyanjana kwa ndondomeko. Kuitanitsa zipatala kuti apange gawo lapadera lothandizira kuthana ndi nkhani zofunika kwambirizi.
Zonse mwazokha, kuyanjana kumakhalabe kovuta. Akatswiri ambiri azachipatala amakhulupirira kuti zolepheretseratu kukhazikitsa kwake sizinachotsedwe komabe ngakhale chidwi chonse choyamba ndi chuma chomwe chagwiritsidwa ntchito.
Kukhazikika kwa EMRs
Kukhazikika kwa deta ya munthu payekha ndi mfundo ina yofunikira yomwe ikukhudzana ndi kukhazikitsa mfundo pakati pa ma syntax zomwe zimagwiritsidwa ntchito popanga zolemba zaumoyo komanso kuthekera kosavuta kunyamula deta iyi pazinthu zosiyana. Kafukufuku wambiri wasonyeza kuti deta yosavuta komanso yosasinthika ikhoza kusintha kwambiri chithandizo cha zaumoyo ndikuwonjezera chisamaliro cha odwala. Komabe, kuthekera kwa EMRs ndi vuto lomwe silinathetsedwe komabe komabe likuyenera kukhala loyenerera kuti likhale ndi dongosolo lovomerezeka la chisamaliro.
Kusinthana kwachinsinsi ndi chitetezo cha chidziwitso cha umoyo wa digito ndi chimodzi mwa zinthu zofunika kwambiri pa gulu la zachipatala. Ochita kafukufuku ochokera ku India amene akuyesa kukhazikitsidwa kwa EHR m'mayiko omwe akutukuka akuganiza kuti kusungidwa kwa mtambo, chitetezo chachinsinsi, ndi kufotokozera mwachinsinsi zonsezi zimayesa opereka chithandizo chamankhwala angatenge kuti apange EHR zoteteza kwambiri. Ziphuphu zina zachitetezo ndi zovuta zowonongeka zakhala zikulembedwa ndipo izi nthawi zina zanyalanyaza zothandiza za EHRs.
Kuphimba thanzi la IT
Kupititsa patsogolo chidziwitso cha thanzi labwino, pa July 28, 2015, bungwe la ONC linalengeza zoposa $ 38 miliyoni pa zopereka zopereka kwa mabungwe 20 ochokera ku mayiko 19 m'dziko lonselo. Chinthu chimodzi chomwe mphotoyi inkayenera kugwira ntchito chinali kuwonjezera kuphatikiza kwa zaumoyo. Pulogalamu yowunikira maphunzilo amtunduwu inanenedweranso kuthandiza anthu kuti adziwe kusintha magulu a deta, kufotokoza deta ndi kusanthula deta, onse ndi cholinga chokwaniritsa zotsatira zabwino ndi ndalama zogwiritsira ntchito mankhwala.
Mapulogalamu ena adayikidwanso kuti athe kuthandiza odwala komanso kuwongolera njira zothandizira, monga mankhwala a Medicare ndi Medicaid EHR. Zochita izi zimalimbikitsa kusinthana kotetezeka kwa chidziwitso cha thanzi. Amalimbikitsanso odwala kupeza zolemba ndi zipangizo zamakono kuti athe kuyankhulana ndi odwala. Cholinga cha pulogalamuyi ndi kuchepetsa kusiyana kwaumoyo ndikupereka chisamaliro choyenera cha chikhalidwe ndi chithandizo cha sayansi. Kusanthula kwaposachedwapa kwa Pulogalamu ya EHR yolimbikitsana ndi Dipatimenti ya Health Informatics ndi Information Management ya College ya St. Scholastica inasonyeza kuti kupita patsogolo kwakukulu kwapangidwa. Komabe, kuti mukhale okhudzidwa kwambiri ndi otsogolera ndikusintha zotsatira za chisamaliro kwa onse, kugwiritsira ntchito ntchito akufunikanso kuwonjezeredwa kwina.
> Zosowa
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